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VOLUNTEER APPLICATION FORM
Thank you for your interest in volunteering for CHILLA! Thank you for your dedication, enthusiasm, ingenuity and your generous offer of assistance.
Please help us to determine how to make the best use of your skills as a volunteer by filling out the questions below:
Home # :
Business # :
Cell # :
What is your preferred method of communication?
How did you find out about CHILLA?
Media (e.g. television, newspaper)
What best describes your current situation?
Please tell us about your availability:
Start Date (dd/mm/yyyy):
End Date (dd/mm/yyyy):
Hours per week:
Please indicate the times when you could be available for volunteering.
(AM: 6:00am - 12:00pm, PM: 12:00pm -10:00pm)
AS A VOLUNTEER YOU CAN
Promote, raise funds and take other initiatives for Chilla.
PLEASE SELECT YOUR AREA OF INTEREST AND EXPERTISE:
Health Education / Awareness
Self Help Programs
This should be an employer/supervisor/head of the institution or an individual known through community involvement that you have known for at least 6 months.
Cell # :
Relationship to Applicant:
TERMS AND CONDITIONS
I hereby authorize CHILLA to obtain references from the above individual in connection with my application for a volunteer position.
I hereby certify that all information included in this application form is true and complete. I agree to all the terms and conditions stated above.
THANK YOU FOR YOUR INTEREST IN HELPING CHILLA!
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