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Email Address *
Name *
Address *
City *
State *
Zip *
Date of Birth *
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Gender
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Phone (cell) *
Phone (other)
Preferred Method of Contact *
Emergency Contact Name and Number *
Church Membership? (name of church)
Volunteer Experience (current/past)
Hobbies/Interests
Clubs/Organizations
Current Employment
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How did you hear about Meals on Wheels?
Preference for Volunteer Work Type *
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What mornings are you available to volunteer? *
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Reference #1 Name *
Reference #1 Phone Number *
Reference #2 Name *
Reference #2 Phone Number *
Are you interested in becoming a member or our Board of Directors?
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Do you know others who may be interested in volunteering?
By my signature below, I acknowledge that I am a gratuitous volunteer for Cherokee County Meals on Wheels, Inc. (CCMOW) and understand that there is no coverage available under the workers compensation insurance policy provided for the employees of CCMOW for any expenses arising out of any injury or illness that I incur as the result of my association with CCMOW. I certify I have liability coverage in force on my vehicle. (Your typed name acts as your signature below.) Please type your full name: *
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