Northwest Hub Volunteer Application
Thank you for your interest in the Northwest Hub! The Hub is a nonprofit full service bike shop and reclamation center. We help disadvantaged Salem residents get bike transportation, lights and accessories in exchange for their community service. We are a passionate group of volunteers and employees dedicated to creating a community in which there are "bicycles for all". This application helps us determine your needs. If you just want to volunteer, that's great too! Leave blank any questions you can’t, or don’t wish to answer. Contact information you provide may be used occasionally to communicate with you about your volunteer schedule, or remind you about unclaimed benefits, and is not provided to third parties.
First and Last Name (or name of group)
Your answer
Email address
Your answer
Phone #
Your answer
Age
Please note that minors must be scheduled separately, and the Hub does not take any participants below the age of 12.
Ethnicity
Gender
What are your needs? (Check all that apply)
For any questions about services we provide and hours requirements, please ask Allen Reinert, our Volunteer Coordinator.
Get the Hub's quarterly email newsletter, informing you about upcoming events and our work in the community?
Do you have a physical condition that could limit your range of motion? List any activities you should avoid (e.g. lifting).
Your answer
Were you referred to the Hub by someone? (e.g. Friend, Counselor, Agency, P.O.)
Your answer
Are you a participant or volunteer with any of these programs or initiatives?
Are you on any of these forms of public assistance? (Check all that apply)
Would you describe yourself as any of the following? (check all that apply)
Please continue to the next section. Almost done!
Next
Never submit passwords through Google Forms.
This form was created inside of Northwest Hub. Report Abuse - Terms of Service