Volunteer Form

Please provide the following contact information:

Name:

Title:

Organization:

Address:

Address 2:

City:     State:

    
Zip Code:                          Country:

Home Phone:

Business Phone:

E-Mail:

 

Please tell us the days and hours that you are available to volunteer (check all that apply):

Mondays                    Mornings                    Afternoons                    Evenings
Tuesdays                   Mornings                    Afternoons                    Evenings
Wednesdays             Mornings                    Afternoons                    Evenings
Thursdays                  Mornings                    Afternoons                    Evenings
Fridays                       Mornings                    Afternoons                    Evenings
Saturdays                  Mornings                    Afternoons                    Evenings
Sundays                     Mornings                    Afternoons                    Evenings

Please tell us the numbers of days/times that you would like to volunteer:

times per week
times per month
periodically

Are you fulfilling Community Service hours ?

Yes No

Below is a list of volunteer opportunities currently available at Birmingham Group Health Services.  Please check all that you are interested in:

Thrift Shop (My Sister's Place) Volunteer:

Sorting, organizing, selling merchandise
Pick up donations in Valley area (truck needed)

Compeer Volunteer (friendship/mentoring program)

I would like to be matched with a person affected by
mental illness in a one-to-one friendship relationship.
I would like to assist or help provide enrichment
activities to Compeer members and volunteers

Valley Substance Abuse Action Council (VSAAC)

I would like to help update VSAAC's resouce directory of alcohol & drug abuse education and
treatment services (involves contacting agencies and updating info via data entry).
I would like to volunteer for VSAAC's B.A.B.E.S (Beginning Awareness Basic Awareness Studies)
program that uses animal puppets combined with storytelling to give practical information about the topics of substance abuse prevention and education to students in pre-school through third grade.

Babysitting

A volunteer opportunity for a baby-sitter for Tuesday evenings from 6:30pm to 8:30pm

Administrative/Clerical Volunteer:

Light typing and general clerical
Data entry
Assemble mailings
Make copies

Fundraising:

I would like to become a member of the Umbrella Resource Committee (raises awareness and funds for domestic violence services).
I would like to help obtain raffle prizes for fundraising events.
I would like to help solicit sponsorship for events.

I would like to assist with special events (check the event(s) that you would be interested in):

Bowl-to-Benefit the Umbrella
Umbrella Back-to-School Adopt A Child Program
Holiday Under the Tree Program
Holiday Gala
Other Events as Needed

Valley Social Club (member-run club for persons affected by mental illness):

Provide a workshop, enrichment, or other how-to instructional presentation (i.e., macrame', crocheting, computer instruction) to members.
Provide entertainment to members.

Specific workshop or entertainment ideas?:

Please tell us about any special skills, interests, or hobbies that you have and would like to incorporate into your volunteer opportunity:

Is there a specific volunteer capacity or program that you are interested in volunteering for that is not listed above? (Please explain):

Thank you again for your interest in volunteering for Birmingham Group Health Services.  Please click the "submit" button below and your information will be forwarded to us.  We will contact you when we receive your information and look forward to speaking with you soon!