My name is... *

First Name

Last Name

Date of birth? *

MM

DD

YYYY

The best number to reach me at is... *

(###)

###

####

I'm available on... *

weekdays

weeknights

weekends

I'd like to volunteer... *

just once

for a short while (less than a year)

for a long time (a year or more)

-and I can make it...

once a week.

once a month.

as needed.

at these specific times:

I'm interested in being... *

(check as many as you want!)

a Special Events Volunteer - (Assist at fundraising events or social events)

a Judaic Volunteer - (Visit a JARC home for Shabbat Dinners or Holiday celebrations)

a Friend-to-Friend Volunteer - (Become a friend to one or more of the people that we serve in a JARC home)

an Office Volunteer - (Help with general administrative duties like filing and copying in the JARC office)

in the Garden Squad - (Help with weeding and maintaining the outsides of JARC Homes)

Have you been referred to JARC by a court-ordered community service program? *

Failure to disclose this information will prevent applicant from having hours validated by JARC to a court official.

Yes

No