Volunteer Registration Form

This 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 Friends@Home 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 Name

M/F*

MaleFemale

Age

Birth Date*

MonthDayYear

Approximate time of birth (10am / 6pm etc. for Hebrew birthday calculation)

E-mail*

Cell Phone Number*

Area CodePhone Number

Address*

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Grade*

TempleAffiliation

Mother's Name

First NameLast Name

E-mail

Cell

Area CodePhone Number

Father's Name

First NameLast Name

E-mail

Cell

Area CodePhone Number

Do you have a friend with whom you would like to volunteer?

YesNo

Friend's Name

First NameLast Name

Friend's Email

Friend's Number

Area CodePhone Number

Please list one or two references. [Teacher, Director of another kids program or Family Friend where you babysat etc.]

Reference #1

First NameLast Name

Phone Number

Area CodePhone Number

Reference #2

First NameLast Name

Phone Number

Area CodePhone Number

If you are under 18 please have a parent or guardian initial the box below.

I give my child permission to volunteer for the Friendship Circle of the West Side

Volunteers!
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 Info@FriendshipCircleWS.org, or call (203) 887-4876

I would like to receive news and updates by email

Volunteer Information

Parents' Information [Teenagers]

References

Parental Consent, Permissions & Volunteer Commitment and Handbook