Your Name:
Email :	preferred contact
Daytime phone:	preferred contact
Evening phone:	preferred contact
Address:
City:	State: Zip:

Do you prefer volunteering in interpersonal situations task oriented situations or both.

Have you volunteered with Help One Child before? Yes No

Check your current areas of volunteering interest:

	Babysitting		Event activities (crafts, games, registrations, photography)
	Respite Care		Event set-up and/or clean-up
	Tutoring		Event Planning/Managment
	Event child care		Church or Ministry Representative
	Prayer network		Phone support
	Preparation/distribution of mailings		Professional assistance (nurse or doctor for health screening)

Other (please specify):

How did you hear about Help One Child?
Special talents or Interests?
Previous Volunteer Experience?