Volunteer Interest Form
Thank you for your interest in becoming a member of our healing community as a Café Companion! Please fill out the information below to help us get to know you and your interests better. Questions with a star by them are required; all other questions are optional--filling them out will help us to better understand our community.
First Name *
Your answer
Last Name *
Your answer
Email *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Phone Number *
Your answer
Address *
Your answer
City *
Your answer
Zip Code *
Your answer
What is your preferred pronoun?
I identify my ethnicity as:
Are you a Veteran?
Current Employer
Your answer
Position/Job Title
Your answer
I am currently:
If a student, what school are you attending?
Your answer
Do you identify as someone in Recovery?
How did you hear about Recovery Café? *
Your answer
Would you like to receive Recovery Café's quarterly newsletter? *
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