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Spreading Sunshine


                               it’s needed most.


      1274 49th Street | Suite 297 | Brooklyn, NY 11219

      Toll Free: 866.MEKIMI1(866.635.4641) | Phone: 718.686.0469

      Fax: 718.686.1551 | Email:

      A volunteer organization serving pediatric patients.


Please Fill In As Much Info As Possible. Fields Marked With Red Asterisks (* ) Are Required.

Title: First Name * Last Name *
Address City State Zip  
Home Phone Cell Phone Can we send text messages? Yes No
Email * (If you don't have an email address, type 'none'.)

Highschool Year Graduated      
Are you currently a student? Yes No If yes, Where?

Current Employer Occupation Phone Number
Previous Work Experience:  

Have you ever volunteered before? Explain.
Which days are you available? Sun Mon Tues Wed Thur Fri Specify Hours:
Language Fluency: Hebrew Yiddish Other
Do you drive? Yes No Do you have access to a car? Yes No
Please check off at least four of the following categories: Check off Box 1 if you know how to do it, or Box 2 if you're willing to learn.
Arts N' Crafts (basic) Glass Etching Pottery
Arts N' Crafts (advanced) Graphics* Puppet Show
Balloon Sculpturing Leather Scrapbooking
Beading Magic Tricks Singing
Ceramic Music** Slideshow*
Create A Book Nails Arts N' Crafts Stamp Art
Dried Flowers Papercuts Studio/Recording
Fondant/ Royal Icing Photography Tile Art
Food Decorating Plaster Wire Shaping
*Specify Program
**Specific Instrument
Is there anything else you know that is not on this list?

Name Phone Relationship
Name Phone Relationship