Title

First Name (required)

Last Name (required)

Email Address (required)

Street Address (required)

City (required)

State (required)

Zipcode (required)

Primary Phone (required)

Alternative Phone

Age if under 18**

Your Availability (required)
I am flexibleWeekdaysEveningsWeekends

Preferred Frequency (required)
1-10 hours per week1-10 hours per monthOccasionally

Check all positions you are interested in. - hours and shifts are available for most volunteer opportunities.

Volunteer positions (required)
Call Center - Food/InfantCall Center - Prescription FinancialCall Center - Bilingual AssistanceCall Center - Transportation RequestsDriver - Client Transportation*Driver - Donation Pickup*Driver - Food Delivery*Pantry - Food Bagger**Pantry - Food Distributor**Pantry - Food Receiver**Pantry - Food Stocker**Seasonal EventsSponsor a Food DriveStudent or Group SSL HoursOther?

* Drivers must be 21 or older and are required to sign an Insurance Addendum.
** Note: Any volunteer under 18 years of age requires adult supervision.

If you have other skills to contribute, please specify:

Any other skills?
AccountingAdministrationFundraisingGrant WritingInformation TechnologyManagement

Comments

Referral?


How did you hear about our volunteer opportunities? Please be as specific as possible, and if web site or publication, let us know which one.

Electronic Signature (required)
Applicant Authorization

By checking this box, I understand that I am making a commitment to Gaithersburg HELP and will take responsibility for tasks assigned to me. I agree to maintain confidentiality for client information and to treat all clients fairly and equally under agency guidelines.