Name(required)

Title

Organization/School

Your Email (required)

Phone

Mailing Address(required)

City, State, Zip(required)

What kind of information do you need?

What are your volunteer interests?
Office helpWebsiteOther marketingSpecial event assistanceFilm/videographyResearchPresentationsCommitteesSpeakers BureauVoices of RecoveryOther

If "Other":

What groups are interested in reaching out to?
General PublicSeniorsYouthAsian communityNative AmericanHispanic/LatinoOther

If "Other":

Are you currently enrolled in school?
NoYes

If yes, which school:

Computer skills:
WordExcelOutlookQuickbooksFileMakerOther

If "Other":

Foreign language skills:

Other skills, training, or talents:

When and how often do you want to volunteer?:

Which days are you available?:
MondayTuesdayWednesdayThursdayFridaySaturdaySunday

Are you available on short notice?:
YesNo

Current employer:

How many hours per week do you work?:

Other current volunteer work:

Please list your work and volunteer experience:

By checking the box below, I give permission to the Evergreen Council on Problem Gambling to obtain information regarding my previous volunteer and/or work experience. I certify that the facts in this volunteer application are true to the best of my knowledge. I hereby release the Evergreen Council on Problem Gambling and its staff from any and all liability for loss, damage, injury, or illness to any person or property which may be incurred through participation in the ECPG volunteer program. I understand that I have the option of refusing to perform any work task that I feel may be unsafe or have the potential for personal harm, and that it is my responsibility to make such a determination.

I agree(required)
Yes

Please type characters from above