VOLUNTEER APPLICATION

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Application Date *

YYYY

Name *

Permanent Address *

Email *

Daytime Phone *

Emergency Contact *

Emergency Contact Phone *

Occupation *

How did you hear about us? *

Volunteer Availability (include days and times) *

Are you willing to be a substitute reader on an as-needed basis? *

Yes

Required

Reading preferences *

I would prefer to broadcast my program live on the air

I would prefer to record my program for later broadcast

No preference

Program preferences *

I would prefer to read local or regional newspapers

I would prefer to read magazines or books

No preference

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This form was created inside of Western Illinois University.