Volunteer Application

Name

Group Name (if applicable)

Street Address

City

State

Zip Code

Date of Birth

Phone

E-mail

Emergency Contact Name

Emergency Contact Relationship

Emergency Contact Phone (Daytime)

Is there any medical history we should be aware of in case of emergency ? (Please describe)

Employment Status

Employer/School

Please list your current and previous volunteer experience/activities/organizations

Why do you want to volunteer with the Second Harvest Food Bank?

How did you become aware of volunteer opportunities with the Second Harvest Food Bank?

Indicate your availability

During Emergencies
Once per Month
Twice per Month
Once per Week (Indicate day and time available)
	Monday	morning	afternoon
	Tuesday	morning	afternoon
	Wednesday	morning	afternoon
	Thursday	morning	afternoon
	Friday	morning	afternoon
Weekends		(available on occasion)

I am interested in volunteering in the following areas: (select all that apply)