|
Community Health Mission
310 Eisenhower Drive, 5B
Savannah, GA 31406
912-692-1451
912-352-3980 Fax
mrittmeyer@chmsavannah.org
We deeply appreciate your interest in our organization and assure you that we are sincerely interested in your qualifications.
A clear understanding of
your interests and background will help us provide the most satisfying volunteer opportunities.
Name___________________________________ Spouse’s Name________________________________
Home Mailing Address___________________________________________________________________
City/State/Zip_________________________________________________________________________
Home Phone_____________________________ Work Phone__________________________________
Email___________________________________ Fax_________________________________________
Alternate Contact__________________________ Phone_______________________________________
Are you employed?________ Where?__________________________ Phone_______________________
Other volunteer experience/contacts________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Schedule restrictions/preferences?__________________________________________________________
____________________________________________________________________________________
Schedule restrictions_____________________________________________________________________
____________________________________________________________________________________
Special abilities/interests_________________________________________________________________
____________________________________________________________________________________
Signature________________________________
Date____________________________________
Notes:_________________________________________________________________
____________________________________________________________________________________ |
