Wrap Around Family Volunteer Form

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Please answer the following questions to the best of your ability. Your answers will help us place you within a team that utilizes your skill set as an individual or family. Please note these answers are just a guide.

Email *

Name of person filling out the form *

Email of person filling out the form *

Address

Phone number *

Are you volunteering as an individual or family? *

If yes to family, please list names. Please include the ages of those under 21

What areas do you feel you/your family can best serve? Please choose all that apply. *

House Cleaning

Laundry

Make or order a meal

Babysitting

Transportation for foster and or bio children

Grocery pick up (not meaning pay for)

Yard work

House maintenance

Provide physical items *purchase or collect

Other:

Required

Wellspring attendance *

Where do you reside? *

Hudsonville

Jenison

Jamestown

Zeeland

Holland

Grandville

Other:

Required

Are you currently serving on a wrap around family team? *

Any other information you feel would be helpful when placing you on a wrap around care team?

Any questions you have for us?

Send me a copy of my responses.

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