Volunteer Registration and Application

Name:

Address:

City:

State:

Zip:

Daytime Telephone:

Evening Telephone:

Email:

Birthdate:

(mm/dd/yyyy)

Gender:

Employment Status:

Employer Name:

(if employed)

Availability:

Please indicate days and times during which you are available to volunteer by checking the appropriate boxes. RIS asks volunteers to commit a minimum of one hour per session.

Time of Day	Monday	Tuesday	Wednesday	Thursday	Friday	Saturday	Sunday
8 AM to NOON
NOON to 5 PM
5 PM to 8:30 PM						--	--

I learned of RIS through:

Magazine
Newspaper
Radio
TV
Friend
Relative
RIS Speaker
Other

There are several areas of responsibility where you can help at RIS. Please check the areas that interest you the most.

	Reading (On-Air)
	Administrative (Clerical and telephone assitance, data entry, mailings)
	Fundraising (Committees for special events, obtaining prizes)
	Outreach and Public Relations (Telephone survey of listeners, public speaker, staff RIS booths at information fairs, assist as special events)
	Technical (Electronic equipment repair, computer programming, Braille production, audio engineering)
	Other

If you have experience relative to your choices, please describe that experience:

Other volunteer experience:

Other affiliations: