VOLUNTEER APPLICATION FORM

Name: ____________________________ Date of Application: _____________

Address: ___________________________________________ Apt. # _______

City: ___________________ State: IL Zip: __________

Home Phone: _____________________ Cell Phone: _____________________

Business Name: ____________________________ Title: _________________

Business Address: ________________________________________________

City: ___________________ State: IL Zip: __________

Phone: _____________________ Email: ______________________________

Date of Birth (MM/DD): _____________

Does your employer: (Please circle a response if known.)

Offer grants for volunteer involvement? Y / N

Have a matched giving program? Y / N

Make in-kind donations of goods or services? Y / N

What type of work would you like to do for the Guild?: (Please check all that apply.)

____ General office (filing, answering phones, etc.)

____ Data entry

____ Word processing (Microsoft Word)

____ Spreadsheet design (Microsoft Excel)

____ Internet research (Internet Explorer)

____ Workstation routine maintenance for Windows XP

____ Website maintenance (Dream Weaver)

____ Database maintenance (Microsoft Access)

____ Server 2003 network maintenance & troubleshooting

____ Fundraising

____ Driving

Direct service to members in the area(s) of:

____ Computer Training

____ Career Development Activities

____ Adult Rehabilitation

Please indicate which of the following skills you currently possess:

Intermediate to advance computer skills using:

____ Microsoft Word

____ Microsoft Excel

____ Microsoft Access

____ Internet Explorer

____ PowerPoint

Adaptive Technology

____ JAWS

____ ZoomText

____ Windows XP

____ Dream Weaver for website design and maintenance

____ Microsoft Access for database design and maintenance

____ Server 2003 Network

Braille

____ Proofreading ability (Grade 2/Contracted Braille)

____ Writing (slate & stylus or Perkins brailler)

____ Transcription (Duxbury)

When are you available? ____ Mornings ____ Lunch hour ____ Afternoons

How did you hear about the Guild?

____ I am a Guild member

____ Guild advertisement

____ Family/friend who has vision loss

____ Internet search

____ Phonebook

____ Other agency (Please specify.)

___________________________________

We appreciate your interest in our organization and for taking the time to complete this application. A staff member will be in contact with you to discuss our current needs and your areas of interest and expertise.

Please submit this application to: Guild for the Blind, Attn: Kerry Obrist, 180 N. Michigan Ave., Suite 1700, Chicago, IL 60601-7463; or fax to (312) 236-8128; or email kerry@guildfortheblind.org.

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