Mekimi.org - Volunteer

Toll Free 1-866-MEKIMI-1
866.635.4641

Spreading Sunshine

Where.....

it’s needed most.

Volunteer

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

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

Fax: 718.686.1551 | Email: mekimi@mekimi.org

A volunteer organization serving pediatric patients.

VOLUNTEER APPLICATION

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

Date:
Title: Mr. Mrs. Miss	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'.)
EDUCATION:
Highschool	Year Graduated
Are you currently a student? Yes No		If yes, Where?
OCCUPATION:
Current Employer	Occupation	Phone Number
Previous Work Experience:
VOLUNTEER EXPERIENCE AND EXPERTISE:
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?
REFERENCES:
Name	Phone	Relationship
Name	Phone	Relationship