Friends of Dorothy Brown

-Required information in BOLD-

Contact Information
First Name
Last Name
Street Address
City, State Zipcode	,
Home Phone
Work Phone
Email Address
Availability
During which hours are you available for volunteer assignments? Weekend mornings Weekend Afternoon Weekend Evening Weekday Morning Weekday Afternoon Weekday Evening
Interests
Tell us in which areas you are interested in volunteering Administration Events Field work Fundraising Deliveries Phone bank Newsletter production Volunteer coordination
Special Skills or Qualifications
Summarize special skills and qualifications you have acquired from employment, previous volunteer work, or through other activities, hobbies or sports.
Previous Volunteer Experience
Summarize your previous volunteer experience.
Person to Notify in Case of Emergency
Name
Street Address
City, State Zipcode	,
Home Phone
Work Phone
Email Address
Agreement and Authorization
By submitting this application, I affirm that the facts set forth in it are true and complete. I understand that if I am accepted as a volunteer, any false statements, omissions, or other misrepresentations made by me on this application may result in my immediate dismissal. As proof of your acceptance of this agreement, please provide your birth month below, and click the 'Accept' button.
Month of Birth

It is our policy of this organization to provide equal opportunities without regard to race, color, religion, national origin, gender, sexual preference, age, or disability.

Paid for by Friends of Dorothy Brown. A copy of our report is filed with the State Board of Elections, Springfield Illinois . State law requires political committees to report the name and mailing address of contributions that exceed $150 in aggregate in a calendar year. Occupation and Employer information is required for contributions over $500. Contributions are not tax deductible.