Volunteer Information Questionnaire

Today’s Date:

Name: Birthday:

Address: Email:

Phone:

How did you hear about The Hawthorne?

Are you a cancer survivor? (optional) Yes No

Diagnosis: Year Diagnosed:

What special talents/gifts would you like to share with us?

In what areas might you be willing to serve?

Greeter Library helper Website development Computer assistant

Program planning Mailings Solicitation/fundraising General volunteer

What day(s) and time(s) would be best for you to volunteer in The Hawthorne?

Any additional comments? We’d love to hear from you!

Please return this form to: The Hawthorne Volunteers

1459 Johnston-Willis Drive

Richmond, VA 23235

FAX 804.330.2174

We look forward to our partnership with you! Call us if you have any questions 330-2136.

We promise to return your call promptly.