Volunteer Application

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

Online (see below)
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

Name of position applying for: *

Date: *

Contact Information

Salutation: *

Name: *

Address: *

City: *

State: *

Zip: *

Phone Numbers

Day: *

Evening: *

Mobile:

Best time to call:

Email:

Emergency Contact

Name:

Day Phone:

Evening Phone:

Relationship:

Availability

Hours:

I can commit this many hours per month

Availability:

My commitment will vary

I am happy to serve anywhere in the Portland Metropolitan area

My schedule is flexible

Please call to discuss my availability

I prefer to serve in this region:

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

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)

CAPTCHA

This question is for testing whether you are a human visitor and to prevent automated spam submissions.

Math Question: * 7 + 7 =

Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.

Copyright 2004-2009 by MIKE Program. All rights reserved.
MIKE Program, Box 91194, Portland, OR 97291
phone: 503.296.7705 ⋅ fax: 503.216.2594