If you want to volunteer with Grace Network, you can print out the form below, fill it in, and mail it to Volunteer Coordinator, Grace Network, PO Box 3902, Martinsville VA 24115. 

VOLUNTEER APPLICATION

Mr., Ms., Mrs., Miss (circle one)

Name _________________________________________________

Social Security or ITIN Number (optional) ___________ ____________ ____________

Address ___________________________________________________________

City ________________________State _______________ Zip __________-________

Phone (H) __________(W) _________ (C) __________(E-mail)__________________

Birth Date _______________________ Highest Level Completed in School __________

Present (or former, if retired) Occupation ________________ Employer _____________

Spouse or significant other _______________________________________________

Are you fluent in any language besides English? If so, which one(s)? ________________________________________________________________________

Do you have computer experience? If so, which programs? ________________________________________________________________________

Church Affiliation/Membership ________________________ City _________________

Special interests, talents, hobbies, why you want to volunteer at Grace Network ________________________________________________________________________________________________________________________________________________________________________________________________________________________

Volunteer Work Preference (check all that apply)

O Food Room                                 O Office Work

O Warehouse Stocking                 O Computer Clerk

O Receptionist                               O Interviewer

O Special Mailings                        O Greeter

O Special Projects                         O Cleaning

O Maintenance and repairs 

Time Commitment and Availability

O Prefer one-time assignment         O On call, as needed         O Once a month

O Once a week                                  O Other ____________________

Volunteer Signature:___________________________ Date:___________________

Please return this form to: Volunteer Coordinator Grace Network of Martinsville and Henry County PO Box 3902 Martinsville, VA 24115