Volunteen Application

    Full Name  
     Date of Birth  
     Preferred Interview Date (Choose 1)  
    City and State    
    Telephone #  Cell Phone #  
    E-mail address  
    Parent or Guardian Full Name   
    Parent Cell Phone  
    Emergency Contact   
    Relationship   Cell Phone  
    School You Attend  
     Grade as of 6/2017  
    Name of School Guidance Counselor   
    e-mail address  
    Special Skills or interests
    Choose the days you are available to volunteer (You can choose more than 1) 
    Hours of the day you wish to volunteer  
      Why do you want to volunteer at RMH? 
     Have you volunteered before  
    If you answered yes, where did you volunteer?
    Have you ever been convicted of a crime?  
    If Yes, please explain
     Electronic  Signature