Haiti Leve Volunteer Application
Name *
( First Middle Last)
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Email Address *
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Phone Number *
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Date of Birth ( Volunteers under 18 must be accompanied by parent/ guardian) *
MM
/
DD
/
YYYY
Address *
(Street # City State Zip Code)
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Occupation
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How did you hear of Haitileve
What drives your interest to volunteer with Haiti Leve
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Are you involved in other voluntary activities/ projects?
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What are your Hobbies and Interest ?
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What do you hope to benefit from volunteering with Haiti Leve
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Please list two character references along with contact information
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What days/times are you best available to volunteer? ( please be specific)
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What are your strengths?
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What are your ares in need of improvement?
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Additional Comments
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