Part One: Your Information
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Have you ever volunteered, in general, before? (Does not affect placement.)
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Yes
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No
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E-Mail Address
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Name
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City or Zip Code
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Phone Number
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Age (If under 18)
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Preferred Time to Contact:
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Mornings
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Gender:
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Male
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Female
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Afternoons
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Phone
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E-Mail
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Preferred Method of Contact:
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Evenings
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Group/Company/Affiliation (if any)
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How you heard about the Communities In Action/ME³
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Volunteermatch.org
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Other:
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Google/websearch
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Somebody I know told me
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Read about it in the news
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Part Two: Your Schedule
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What type of volunteer opportunity are you up for?
Check the boxes next to the option(s) that appeal to you.
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One Shot Deal
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Try it once, see if/how I like it
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Short-Term Commitment (less than a week or two)
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Occasional (once or twice a month)
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Semi-Often (once a week)
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Often (a couple times a week)
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Full-Time (five days or more a week)
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Long-Term Commitment (opportunity lasts over 6 months)
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What part(s) of the week and time(s) of the day are you available/would you like to volunteer?
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Part Three: Your Skills & Talents
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1. List any special talents or skills you have/have been trained in, and describe them.
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Part Four: Special Interests and Causes Near & Dear
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1. List any special interests you have and describe them.
Examples: drawing, plants, foreign cultures, etc.
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2. Are there any issues or causes that you hold dear for any reason?
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5. Are you interested in being called upon to help with a variety of needed tasks should a Natural Disaster or other
major event affect our community?
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No
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Yes
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Part Five: Personal Preferences
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1. Are you open to accepting leadership positions in efforts that might need additional leaders?
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Yes
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No
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2. Do you mind speaking in front of crowds (or would you like to work on it), or would you prefer not to?
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Would rather not
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Don't mind speaking in front of crowds
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No preference
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Don't normally speak in front of crowds, but would like to work on it
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3. Communities In Action participants have the option of receiving a monthly e-newsletter with a list of some
featured volunteer opportunities and ME³ and Communities In Action news. Would you like to receive this?
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Yes
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No
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Part Six: Team ME³ & Group Activities
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ME³ volunteers will, on occasion, volunteer as a group for organizations, outreach projects, or special events.
Volunteers participating in this team may be of any age or background, but one rule applies: they must be spirited,
enthusiastic and cheerful! Are you interested in hearing about opportunities to work with this team of volunteers?
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Yes
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No
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Part Seven: Comments? Addendums?
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Did we miss anything? Have anything else you'd like to tell us about your volunteer preferences or needs?
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Before your enrollment in Communities In Action is approved, you must read and agree to participation terms as stated on
our Communities In Action Waiver. Participants under 18 must print these waivers (printable version here), have their
parents or guardians sign them, and mail them to: ME³, P.O. Box 10683, Raleigh, NC, 27605
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