Kaleidoscope Volunteer Application
Email address *
Name *
Address *
City *
State *
Zip *
Phone (Cell)
Phone (Home)
Phone (Work)
Place of Employment *
Social Security Number (for OSBI check) *
Date of Birth *
MM
/
DD
/
YYYY
Please describe your personal, professional, and/or volunteer experiences with children, teens, and adults. *
What experience have you had with grief? *
Please tell us your reasons for applying as a facilitator at Kaleidoscope. *
A copy of your responses will be emailed to the address you provided.
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