Volunteer Interest Form
Thank you for your interest in volunteering for the Clackamas Service Center (CSC). Please complete the general volunteer application and a staff member will be in touch with you shortly. 
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Name *
First and last name
Pronouns
Date of birth
MM
/
DD
/
YYYY
Email *
Phone number *
Mailing address *
Emergency contact (name, relationship, phone) *
Medical information we should know (e.g., allergies)

Please list any languages you speak, besides English, & rate your language listening, speaking, and writing ability – beginner/novice/fluent.

I prefer to be contacted by:
 *
I authorize CSC to share my contact information with other volunteers for the purpose of filling shifts.
 *
Would you like to join our monthly bulletin email list?
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I am available to volunteer
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Based on your previous response, how many hours would you like to spend volunteering at CSC?
 *
Please indicate your availability by selecting all the volunteer shift slots you can commit to below. *
Required
Are you interested in being called for last-minute volunteer shifts if available?
 *
Using a scale of 1 = Least Preferred and 5 = Most Preferred, please rate the following volunteer roles. *
1
2
3
4
5
Shower and Laundry Attendant (Location: Anna's Annex)
Kitchen Coordinator (Location: Center)
Grocery Delivery Driver (Location: Food Hub)
Clothing Room Attendant (Location: Anna's Annex)
Grocery Box Builder (Location: Food Hub)
Front Desk Receptionist (Location: Anna's Annex)
Can you safely lift 10 pounds? Are you comfortable performing mild to moderate physical activities (e.g., prolonged periods of standing and sitting)?  *
How did you hear about volunteer opportunities at our organization?  *
Please let us know what is important to you about volunteering. Why do you want to volunteer at CSC? What do you want to get out of your volunteer experience?
 *
I have read and agree with CSC’s Commitment to Anti-Racism.
 *
Required

I agree to abide by the rules of CSC. Moreover, I understand that my volunteer status at CSC provides me no special privileges or financial compensation and can be terminated at any time for any reason.

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Required
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