Welcome to ASC - Volunteers

Name: *
Address:*
City:*	State:*
Zip Code:*	E-Mail:*
Home Phone:	Best time to call:
Work Phone:	Best time to call:
School (if applicable):
Level of Spanish: Please mark the option which most closely describes your skill level.
Completely fluent and literate Speak fluently; read and write fairly well Read and write very well; speak and understand fairly well Read, write, speak and understand fairly well Able to speak and understand fairly well, but read and write minimally Able to read and write fairly well but speak and understand minimally Minimal skills (know key words and phrases) None
Level of English: Please mark the option which most closely describes your skill level.
Completely fluent and literate Speak fluently; read and write fairly well Read and write very well; speak and understand fairly well Read, write, speak and understand fairly well Able to speak and understand fairly well, but read and write minimally Able to read and write fairly well but speak and understand minimally Minimal skills (know key words and phrases) None
How often do you wish to volunteer?

Is there any specific day or time you have in mind? If so, please specify

Do you have a specific job in mind? If so, please specify

Why do you wish to volunteer at ASC? Please mark the reason(s) which were most important to you in deciding to volunteer at ASC.
I want to practice/become fluent in Spanish/English. I want to help people who are less fortunate than myself. I want to meet new people. I am Hispanic and want to help other Hispanic people. I am a former client/patient/recipient of services and want to give something back. I feel my skills are needed here. I know someone who is/was volunteering/working here and told me about the organization. I wanted to meet Hispanic people and/or people who speak Spanish. I am often bored or lonely and am looking for something to do. I believe in the values of the agency and/or the work the agency is doing in our community. I read/heard about the agency and it seemed like a worthwhile cause I am required (by school, work, court, church, etc.) to do volunteer work. I have volunteered somewhere else and enjoy volunteering. I was asked to volunteer at ASC. I am looking for new experiences. I don't have much money, so I want to donate my time. I am a member of the United Methodist Church and want to support the church's efforts. I believe it is my social/religious obligation. It is a part of doing God's work. I am looking for a specific kind of volunteer experience which I believe is available here. (Please specify) Other (Please specify)
What are your talents, interests, and/or experiences? Please check all which apply.
Radio programming		Singing/Music
Answering telephones		Child care
Publicity		Medical Care
Fundraising		Nursing
Working with computers		Education/Teaching
Paperwork		Public speaking
Filing		Janitorial/Cleaning
Art work		Cooking
Writing		Landscaping/Yard work
Typing		Carpentry
Translating written material		Electrical
Interpreting		Maintenance
Other(Please specify):
Special Qualifications: Please list any degrees and/or special license or certification which you currently possess, or paste a resume here.

References:
Mr. Mrs. Phone: Relationship: Mr. Mrs. Phone: Relationship:
Where did you hear about Acción Social? Please check all which apply.
A television report on channel A newspaper article in At work At school Church A social service agency A flyer I found/received at A friend/acquaintance Was contacted by ASC Other: Based on your answers above, please elaborate more on where you heard about ASC
Date/Fecha (mm/dd/yyyy):*

* Items are required