FC Teen Volunteer Registration

Volunteer's Information

Full Name

First Name Last Name

Birth Date

Month Day Year

Gender

Male Female

Address

Street Address
Street Address Line 2
City	Province
Postal Code	Country

Home Phone Number

Area Code Phone Number

Cell Phone Number

Area Code Phone Number

E-mail

School Attending

Grade Currently In

School Principle

School Phone Number

Area Code Phone Number

Languages Spoken

How did you hear about Friendship Circle?

Mother's Information

Full Name

First Name Last Name

Home Phone Number

Area Code Phone Number

Work Phone Number

Area Code Phone Number

Cell Phone Number

Area Code Phone Number

E-mail

Occupation (optional)

Father's Information

Full Name

First Name Last Name

Home Phone Number

Area Code Phone Number

Work Phone Number

Area Code Phone Number

Cell Phone Number

Area Code Phone Number

E-mail

Occupation (optional)

Medical Information

Emergency Contact Other than Parents

Relationship to Person Above

Contact Number One

Area Code Phone Number

Contact Number Two

Area Code Phone Number

Please list any allergies or medical conditions that we should be aware of:

I would like volunteer for

Friends at Home Sunday Circle Holiday Programs All of the above

Best day available

Best time available

I have my own transportation

Yes No

I would like to volunteer with my friend (optional - please specify name of friend)

Agreements

I agree to keep all information confidential.

I agree

I understand that community service forms will ONLY be issued for volunteering that is recorded on the mileage program.

I agree

I understand that I am committing to volunteer, and that you will be relying on me as a buddy for one of the children. In the event that I am unable to volunteer, I will notify the Friendship Circle at least three days in adavnace and will try to find a substitute.

I agree

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