Volunteer Sign-in Sheet - Project Chicken Soup



Volunteer Sign-in Sheet Today’s Date: _____________

Birthday: _____________

Are you over 18? _____________

Name:

Address:

City: Zip:

Phone: home ( ) Cell ( ) Work ( )

E-Mail: Group or Organization:

Emergency Contact: Phone ( )

Occupation: Employer:

Kitchen Volunteer

[ ] Regular – (previous service)

[ ] First time

[ ] Would like to be contacted for future involvement

[ ] Community Service - School: Grade: Hours needed:

Delivery Volunteer

[ ] Have signed up to deliver by email or phone

[ ] Not signed up, but can deliver today (approximately 11:45-2:30)

[ ] Would like to deliver in the future

Today & Future - Rank your 1st, 2nd and 3rd choice, if applicable. Some areas may not be available at this time.

[ ] Hollywood [ ] West Hollywood

[ ] Silverlake [ ] Long Beach

[ ] South Los Angeles [ ] Santa Monica

[ ] Los Angeles – east of the kitchen [ ] Downtown

[ ] San Fernando Valley - west [ ] San Fernando Valley – east

Other Volunteer Opportunities

[ ] Shopping [ ] Phone/Office Support [ ] Speaker’s Bureau

[ ] Special Events [ ] Fundraising [ ] Truck or SUV available

[ ] Special skills or expertise you might have to contribute:________________________________

Kitchen Volunteers Initial_________ I have read and understand the Kitchen Rules & Regulations as they related to my volunteer service at Project Chicken Soup.

Delivery Volunteers Initial_________ I have read and understand the Delivery Rules & Regulations as they relate to my volunteer service at Project Chicken Soup. I further attest that I have a current California State-required basic liability insurance and a valid driver’s license.

I realize that I am making a serious commitment to volunteer a portion of my time and energies to assist Project Chicken Soup as a volunteer. I further agree to maintain complete confidentiality in respecting the privacy rights of all direct and indirect participants in any Project Chicken Soup activities.

I certify that all of the information I have provided is true and complete.

Signature_____________________________________________________ Date___________________

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