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