Thank you for your interest in volunteering with MIKE program. You may send the "Volunteer Information" form in one of two ways:

1. Online (see below)
2. Mail

Please attach any additional information that would tell us what you see as the best fit for your interest.

INSTRUCTIONS FOR PRINTED FORM: After you print the "Volunteer Information" form, please fill in the information on the form or copy the questions and answer them and mail to:

MIKE Program
Box 91194
Portland, OR 97291

ONLINE INSTRUCTIONS: After filling in the information below, click on the "SUBMIT" button. An email with the given information will be submitted.

Position applying for: *

Date: *

Salutation: * Ms.Mr.MissMrs.Dr.

Name: *

Address: *

City: *

State: *

ZIP: *

Phone - Day: *

Phone - Evening: *

Phone - Mobile:

Best time to call:

Email Address:

Emergency Contact: Name:

Emergency Contact: Phone - Day:

Emergency Contact: Phone - Evening:

Emergency Contact: Relationship:

Availability - Hours:

I can commit this many hours per month

Availability - My commitment will vary

Availability - Place: I am happy to serve anywhere in the Portland Metropolitan area

Availability - Place: I prefer to serve in this region:

Availability - Schedule: My schedule is flexible

Availability - Schedule: I am generally available to volunteer during the following days and times:

Please enter hours available Morning, Afternoon, and Evening for each day of the week.

Availability - Please call to discuss my availability

Education and Employment Background: *

Credentials, Degrees and Skills: (Experiences and interests that would help us to understand how best to make this an outstanding experience for you with the MIKE Program)