Volunteer InformationThis form is for volunteers to sign up. Choose the program/s in which you'd like to volunteer.TEENAGERS: Please complete all the fields below including your parents' info.ADULTS: Please skip the parent's info, unless you really want us to call them :) Programs in which I would like to volunteer:*The [email protected] Program (see handbook for details)The Friendship Circle Hebrew School, Sunday morningsThe after School Clubs: Art, Baking, Music, Martial Arts, Joga etc.Full Name*First NameLast NameM/F*MaleFemaleAgeBirth Date*1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - DecemberMonth12345678910111213141516171819202122232425262728293031Day201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920YearApproximate time of birth (10am / 6pm etc. for Hebrew birthday calculation)E-mail*Cell Phone Number*Area CodePhone NumberAddress*Street AddressStreet Address Line 2CityState / ProvincePostal / Zip CodePlease SelectUnited StatesAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanThe BahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChilePeople's Republic of ChinaRepublic of ChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCook IslandsCosta RicaCote d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonThe GambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNagorno-KarabakhNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandTurkish Republic of Northern CyprusNorthern MarianaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint BarthelemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSomalilandSouth AfricaSouth OssetiaSpainSri LankaSudanSurinameSvalbardSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTransnistria PridnestrovieTrinidad and TobagoTristan da CunhaTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamBritish Virgin IslandsUS Virgin IslandsWallis and FutunaWestern SaharaYemenZambiaZimbabweOtherCountryGrade*TempleAffiliationParents' Information [Teenagers]Mother's NameFirst NameLast NameE-mailCellArea CodePhone NumberFather's NameFirst NameLast NameE-mailCellArea CodePhone NumberDo you have a friend with whom you would like to volunteer?YesNoFriend's NameFirst NameLast NameFriend's EmailFriend's NumberArea CodePhone NumberReferencesPlease list one or two references. [Teacher, Director of another kids program or Family Friend where you babysat etc.]Reference #1First NameLast NamePhone NumberArea CodePhone NumberReference #2First NameLast NamePhone NumberArea CodePhone NumberIf you are under 18 please have a parent or guardian initial the box below.Parental Consent, Permissions & Volunteer Commitment and HandbookI give my child permission to volunteer for the Friendship Circle of the West SideVolunteers! Please read this Volunteer Handbook before we meet - and let us know you did!Volunteer Handbook:I carefully read the Volunteer Handbook and agree to follow the standards stated within.The Friendship Circle sometimes takes photos of events and uses them - without names - for PR.By checking this box, you agree to allow the Friendship Circle to use your (child's) picture.In order to provide the best volunteer experience for the volunteer as well as the child with special needs, we require that all volunteers attend a session of learning and instruction given by experienced instructors. We will arrange for times and places that work for multiple volunteers or arrange for private instruction sometime before you begin to visit your child. Upon submission of this form you will be contacted to set up a meeting. This does not apply to return volunteers.We look forward to meeting you.For more information please contact Chana Mushka at [email protected], or call (203) 887-4876I would like to receive news and updates by emailSubmitShould be Empty: This page uses TLS encryption to keep your data secure.