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VOLUNTEER FORM

* indicates required field

*NAME:    

*ADDRESS:    


*TELEPHONE:

Home:        Work:        Mobile:  


*E-MAIL:    


*Are you at least 18 years of age?
(Volunteers under 18 years require parent/guardian permission)  


VOLUNTEER EXPERIENCE (give dates and description of work):


Do you speak any language other than English?  If yes, please give details:


Do you have your own transportation?


Do you have Red Cross certification in CPR, first aid, ALS, PALS, etc.?  Please list.


*Do you have a valid passport?  


Do you have any hobbies or special skills?  If yes, please give details:


What interests you in being a volunteer with CURE Foundation?


*AVAILABILITY:

Start Date:        End Date:  

Additional information about your availability:


*EDUCATION (highest level completed):   

*Are you currently a student?  


PROFESSIONAL SKILLS/ABILITIES:


REFERENCES:



In case of emergency or illness, please notify:

*Name:    

Relationship:    

*Address:    

*City:       *State/Province:  

*Zip/Postal Code:       Country:  


*Please solve the following equation to verify your request:

9 + 8 =


      
 
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