Volunteer Application



Personal Contact Information

Please enter your full name and at least one way to contact you:
First: Middle: Last:

Home Address:
City: State: Zip:
Home Phone: ( )

Business Address:
City: State: Zip:
Business Phone: ( )

E-Mail Address:
Fax Machine: ( )

Interests and Skills

Please check all activities that interest you:
CPR/First Aid Instructor HIV/AIDS Educator Water Safety Instructor
AFES Case Worker Local Disaster Relief Out-of-Area Disaster
Blood Drive Assistant Blood Recruitment Office Support
Public Relations Fund-Raising Support Computer Assistance
Other:

Briefy comment on your qualifications, reason for application, etc:

Availability

Please select the times you would like to volunteer:
Weekday Daytime Weekday Evenings Weekends

Please specify which days you're available, or if you're interested in special projects, etc.:

Submit Information

When you click submit, this information will be e-mailed to ovchapwv@crossnet.org.   If you do not want to submit this form electronically, use your browser's print option; then mail the printed copy to: 193-29th St., Wheeling, WV 26003.   The information will only be used to find the best volunteer position for you.




Select one of these links after submitting:

Back to the Volunteer Page Back to the Chapter Homepage