Volunteer Interest Form

Name:
Bar number:
Street address:
City State Zip
Day phone:
Evening phone:
Email:
Fax:

During which hours of the weekday are you available?

Day

Evening

During which hours of the weekend are you available?

Day

Evening

What type of assignments do you prefer?

Short-term	Long-term	1-2 yrs.
As needed

Where would you prefer your assignment be located?

DC only	Metro Area	My state
Outside my state

Starting when? Interest areas: Assist w/special events Communications Community activities Consumer protection Education Health and fitness Helping others w/finances Utilizing your legal skills Management Public relations Work with children Work with older adults Pro Bono

Would you like to be added to our email list for updates on community outreach efforts?

Yes No