Volunteer Application

Name:
E-MAIL:
Address:
City:
State:	Zip/Postal Code:
Phone - Home:
Phone - Work:
May we add you to our mailing list? Yes No If yes, may we share your name with other local LGBT agencies? Yes No
Current employer
Position held
How long have you been working in this position?

Volunteer Opportunities
I am interested in (check all that apply):
Direct Service: Peer Counselor/Office Support (incl.answering peer counseling & amp; business lines) Speakers' Bureau Support Group Facilitator (includes separate application process) Coordinator Positions: Community Partnerships Coordinator Computer Resources Coordinator Directory/Ad Sales Coordinator	Executive: Board Membership (Executive Committee member will contact you) Project Positions: Special Events Data Entry/Computer Work Community Event Shift Work Newsletter/Media Float Pool Community Thrift Store
Other:

Skills, Training, Interests If applying for coordinator positions, please be sure to note all applicable experience, such as web design, LAN, specific program knowledge, media, etc.

Previous volunteer experience:
Why are you interested in volunteering at OutReach?
What special qualities can you bring to OutReach?
Please list two people we may contact about your qualifications as an OutReach volunteer:
Contact #1
Name:
E-MAIL:
Address:
City:
State:	Zip/Postal Code:
Phone:
Relationship:
Contact #2
Name:
E-MAIL:
Address:
City:
State:	Zip/Postal Code:
Phone:
Relationship:
*If you have any questions, please call Callen at 255-8582. Thanks for your interest!