Volunteer Data Form

VOLUNTEER DATA FORM

This form is designed to help both CMUS and you derive the greatest benefit from your willingness to serve as a volunteer. As much as possible, CMUS wants to be able to match your interest, skills and availability with the many ways you can help CMUS serve our community. Information about your mediation-related training and experience, as well as other volunteer activities, will enable CMUS to develop and maintain an automated database that will help you stay connected to CMUS. Should any of the information on this form change, please notify CMUS.

* Indicates required field

Date completed *

Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

Mobile Phone *

Email *

Gender *

Male Female

Birth Date *

Race/Ethnicity *

Education Level *

Languages and proficiency *

How did you become aware of CMUS *

Why are you interested in becoming a volunteer with CMUS *

When are you available for volunteering at CMUS (You may check multiple days and times) *

Daytime Evenings Weekends

Where are you able to mediate (Check all that apply) *

Cecil County Kent County Queen Annes's County

Comments, please include any mediation training and experience that you have as well as any other skills or interests that you have in areas such as, but not limited to: board membership, community outreach, computer assistance, fundraising, intake, mediation, website/newsletter, training assistance, other *

Submit