Project Homeless Connect 4: West County Community Volunteer Form

We need your help!
Donate your time for a one-day/one-stop shop to offer a variety of services to people experiencing homelessness; connecting them with benefits, medical care, substance abuse and mental health counseling, social services, housing and shelter.
Download the printable form (PDF)

Full Name:
Mailing Address:
City:
Zip:
Home Phone:
Cell Phone:
e-mail address:
How did you hear about this event?
Did you participate in Project Homeless Connect 3 (September 10, 2008)?
Yes	No
Are you coming on behalf of (please check all that apply):
County	Other affiliation (faith/non-profit/service club)	None

Availability (check all that apply):
2 - 6 p.m. specifically for setup day-before-event (June 16)
7 a.m. - 1 p.m. (specifically for volunteer check-in table, June 17)
7:15 a.m. - 12:30 p.m.
12:15 - 4 p.m.

Which volunteer position(s) are you interested in (check all that apply)?
Set up day before event (June 16th)
Volunteer Check-in (June 17th - must arrive early: 7 a.m. - 1 p.m.)
Translation - Language(s):
Ambassador
Food Services
Do you have any limitations that must be considered (please list):

Thank you for your interest and your generosity!
Please fax printable form to: 925-313-6761.

Content provided by the Homeless Programs of Contra Costa Public Health Division. For more information, call 925-313-6124.

Project Homeless Connect 4: West County Community Volunteer Form

Availability (check all that apply):

Which volunteer position(s) are you interested in (check all that apply)?