Rockin' 4 Relief STL 2019 Volunteer Form
IN MEMORY OF CHIEF JIM SILVERNAIL

***PLEASE READ CAREFULLY!***

Thank you for your interest in our Rockin' 4 Relief 2019 event in St. Louis, MO! Our event is being held on SATURDAY, NOVEMBER 2nd, 2018.

Rockin' 4 Relief is a nonprofit organization that raises money for families of police officers, firefighters, EMTs, and paramedics who were killed in the line of duty. Twice a year, we host a "rock-a-thon" where we send volunteers to different locations around the city to rock in rocking chairs for 10 hours straight and collect money from the customers who walk by. Since 2009, we've raised $200,000 including a $13,000 donation from Ms. Oprah Winfrey.

Prior to the event, we will have a meeting where we will explain how November 2nd will work and we will give you all of the supplies you need.

If you are volunteering as a large group (10+), we can work something out where I can come to you and give you all of the information separately during your regular meeting time.

Important notices:
*Both teenagers and adults are needed! Each location requires someone 18 years or older at every location at all times.
*Only one volunteer per location will actually be rocking in the rocking chair, the rest will be passing out fliers and talking to people
*All information submitted on this form will be kept private.
*If you cannot attend the weeknight meeting, please still feel free to sign up and we can work something out but PLEASE try your best to attend so everyone is on the same page

If you have any comments, questions, or concerns, feel free to reach out to Jennifer Rubin at rockin4relief@hotmail.com.

THANK YOU for your interest in Rockin' 4 Relief and we are looking forward to having you!
Email address *
Name *
Your answer
Age *
Your answer
Phone Number *
Your answer
Gender *
Address
*We only need this if you want a community service hour letter
Your answer
City
*We only need this if you want a community service hour letter
Your answer
State
*We only need this if you want a community service hour letter
Your answer
Zip Code *
Your answer
Are you able to stay all day on Saturday, November 2nd, 2019? *
If you said NO to the question above, what time can you start on November 2nd, 2019?
Time
:
If you said NO to the question above, what time do you have to leave by on November 2nd, 2019?
Time
:
Have you volunteered for Rockin' 4 Relief in the past? *
TEEN volunteers only: School *
(Put N/A if you are an adult volunteer)
Your answer
TEEN volunteers only: Year in School *
(Put N/A if you are an adult volunteer)
Your answer
TEEN volunteers only: Is your GPA over a 2.0? *
(Put N/A if you are an adult volunteer)
ADULT volunteers only: Occupation *
(Put N/A if you are a teen volunteer)
Do you have a rocking chair available for us to borrow on November 2nd, 2019? *
Do you have transportation for a rocking chair? *
Pick 3 jurisdictions you can go to for the day *
Required
Are you able to go to a location that is not in your top 3 listed above? *
T-shirt size (not guaranteed) *
List names of people you want to be at the same location as you. Please list both first and last names.
Your answer
Do you have any questions for us?
Your answer
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