PIRS

Volunteer Application

Name:

Email Address:

Address:     [apt. #]:

City:     State:     Zip Code:

Phone Number: ()-

SSN#:

Driver's Lic#:

Emergency contact:     Relationship:

Address:     Phone Number: ()-

Accommodations Needed:

Languages:

Spanish

French

Asian

Hand Signing

Other Languages:

Volunteer/Background:

Referral {How did you find us?}

Days available (Please check all that apply)

M

T

W

Th

F

 

A.M.
[10-1]

P.M.
[1-4]

Other
(Please Specify)

Comments:


PIRS
VOLUNTEER INTEREST LIST

Typing     wpm

Computer: MSWord     MSAccess (Data entry)

Filing
 

Receptionist/Phone
 

Mailings
 

Preparing Newsletter
 

Library/Research
 

Transcribing
(cassettes, Braille)
 

Reading/Writing
(correspondence, bills, etc. for visually impaired)
 

Systems Advocacy
(phoning, letter writing, arrange for speakers, etc.)
 

Field Surveys on Accessible Housing
(training and mileage reimbursement provided)
 

Public Relations
 

Peer Support (Must have a disability)
 

Fund Raising
 

Gardening
 

Photography
 

Accounting/Auditing
 

Carpentry/Handyman
 

Interpreting
(sign, finger spelling, Spanish, etc.)
 

   PLEASE FILL OUT THIS FORM, PRINT AND MAIL IT TO:

VOLUNTEER APPLICATION
C/O Placer Independent Resource Services
11768 Atwood Rd. #29
Auburn, CA 95603

 

 

Please email comments or questions about web site to Webmaster
Copyright © 2002, 2003, 2004, 2005, 2006, 2007, 2008 Placer Independent Resource Services
Updated: July 23th, 2008