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Full Name (First, Last)
Address (# Street, City, State)
Monday-Friday Evening only
An hour every few weeks
1-2 hours a week
Call me anytime!
Skills, Resources & Preferences
Where can you help? (Check all that apply)
SKILLS: I can speak a foreign language (please specify in the "other" section)
SKILLS: I have computer/tech skills
SKILLS: Other professional skills (please specify in the "other" section)
RESOURCE: I have a car/truck/trailer to run errands/make deliveries/etc
PREFERENCES: Phone well-checks
PREFERENCES: Neighborhood Point Person
PREFERENCES: Delivery to doorstep
PREFERENCES: Helping get the word out about our effort
PREFERENCES: Organizing or back-end support
Do you have a background check that can be provided? If so indicate from which location.
LANL Security Clearance
Other Background Check (Please specify in the "other" section)
I do not have a background check
Is there anything more you would like us to know?
During the time that I serve a volunteer/member of the All Together Los Alamos effort, I may gain access to information that is considered confidential and/or proprietary. I agree that I will not use, publish or disclose such information during or subsequent to my participation in the All Together Los Alamos effort. I hereby certify that I have read, understand and agree to these terms.
Yes, I understand
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