Second Harvest Food Bank of East Central Indiana

Serving Blackford, Delaware, Grant, Henry, Jay, Madison, Randolph, and Wabash Counties

Special thanks to:

Volunteer Registration

SCHEDULE A TIME FOR YOU TO VOLUNTEER

Volunteer Group:
First Name:
Last Name:
Address:
City:
State:
Postal Code:
Email:
Phone:
Alternate Phone:
Date of Birth:
Emergency Contact:
Emergency Contact Phone:

School/Employment Status:	In School Employeed Neither
School Name, if applicable
Employer Name, if applicable

Volunteer Interests:
If you are volunteering to fulfill a community service requirement, please tell us about the assignment:

Indicate when you are available to volunteer. We will contact you for scheduling.
Weekdays	Saturday
Morning	Afternoon
Once/Twice a month	Once/Twice a week
Everyday	I'm available on short notice
Additional comments:


Typically, volunteers help sort, clean and box food in our warehouse. Please indicate which additional opportunities interest you (check all that apply)
Administrative Support	Kids Cafe
Fork Truck	Spokesperson
Special Event	Tailgate
Truck Driving	Grant Writing
Advertising/Marketing	General Labor
Please describe any physical restriction or limitations you may have:


How did you learn about us?
Second Harvest Food Bank newsletter	Website
TV	Radio
Friend	Employer
Other Newsletter	Organization