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Mind&Melody Volunteer Application
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* Indicates required question
Contact Information
Name
*
Your answer
Are you at least 14 years old?
*
Your answer
E-mail
*
Your answer
Phone
*
Your answer
Facebook (optional)
Your answer
Closest Location
*
Miami
Boca Raton
West Palm Beach
Jupiter
Treasure Coast (Stuart/Jensen/PSL)
Other:
School
Your answer
Preferred method of communication
*
Phone Call
Text
E-mail
Facebook
Required
Availability
How often would you like to attend sessions?
*
Weekly
Every Other Week
Monthly
Other:
Required
We ask that volunteers attend a session at least once a month. Can you commit to this?
*
Yes
No
Do you have your own means of transportation?
*
Yes
No
Please provide days/times this week that you’re available to talk for a short interview on the phone or video chat via GoogleHangouts?
*
Your answer
Mind&Melody Questions
Which positions interest you?
*
Session Leader - teaches the music curriculum to participants with dementia (music background required/training provided)
Volunteer Musicians - performs music at sessions
Volunteer Non-Musician - aids participants with music activities
Fundraising - plans a fundraiser for Mind&Melody
Other:
Required
Briefly tell us why are you interested in this program and what do you think you will gain from the experience?
*
Your answer
Why do you think you would be a good volunteer? (skills, experience, qualities)
*
Your answer
Besides English, do you speak any languages fluently?
*
Your answer
Musical Experience
List musical activities you participate in and instruments you play
*
Your answer
How did you hear about Mind&Melody?
Your answer
Please list any additional comments, concerns or questions below:
Your answer
Please list any other skill sets (music and non-music related):
Your answer
(Optional) Refer a friend who would be interested:
Name
Your answer
Email or Phone
Your answer
Instrument
Your answer
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