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Gilda’s Club Twin Cities Volunteer Application

If you are interested in volunteering for Gilda's Club Twin Cities, please fill out the form below:

Gilda’s Club Twin Cities Volunteer Application

Application Date

Name

Date of Birth 19

Address

City State Zip

Home Phone

Cell Phone

Work Phone

Email

Preferred contact: phone OR email


Current Occupation

Employer

Employer Address

City State Zip

List your Skills and Interests
Examples: Office Work/Computers/Arts &Crafts/Photography/Gardening/Landscaping/ Construction/ Working with Children/Fund-raising/Event-planning/Fluency in a Foreign Language


Gilda’s Club Volunteer Activity Preferences:
Potluck suppers
Website design
Thank you gift bags
GildaGram (newsletter)
Historian
Marketing
Outreach
Health Care Events
Research

List any health/physical limitations, including allergies:


Indicate your preferred day(s) and time period(s)

Monday Tuesday Wednesday Thursday Friday Saturday Sunday

Availability (preferred time):

Expected Commitment
Short Term (0-3 mos)
Long Term (>3 mos)
Special Project



Emergency Contact Information

Name Relationship

Work Phone Home Phone


Please list two References (not a relative)

Reference #1 Name

Street City, State, Zip

Phone Email

Years known Relationship

Reference #2 Name

Street City, State, Zip

Phone Email

Years known Relationship



If printed, please sign and date our application and return to the address below.

Signature ____________________________________________________


Date ________________________________________________________


Parent/Guardian Signature (if under 18 years of age)

____________________________________________

Please complete & return to:
Carrie Puterbaugh, Volunteer Coordinator
5145 Xerxes Ave S
Minneapolis, MN 55410






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