Student Application Form
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4Student Volunteer Application
Date: ________________
Name: __________________________________________________________________
Last
First
Middle Initial
Address: ________________________________________________________________
Street
City
State
Zip
Phone Number: __________________________ Cell Phone: ______________________
E-mail: _________________________________ Birth date: ___________________
Age: ____
Grade: _______
School: ___________________________________
*Volunteers must be 15years old to volunteer at Reutlinger Community
How did you hear about our program: _________________________________________
Please list the times you will be available for our volunteer opportunities. We understand that these times
and dates may change at your discretion. We so appreciate your help and will do whatever we can to make
these times mutually enjoyable.
RCJL reserves the right to select those they feel are appropriate to work with the elderly.
Activity
Days
Times
Small Group Activities
Personal Escorts
Computer Help
Walking/Outing Escorts
Games –bingo chess, checkers,
poker, scrabble, bridge, cards,
mah jong
Clerical Support/mailings
Musicians
Special Events/Socials
Entertainment-
dancing/singing/acting
Religious Service Assistance
Saturday Morning 9am- 11.30am
Friendly Visitor
Art Program
*Requires long term commitment
Feb 2013
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Parent category: Business