Wufoo

Name * First Last
Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Email *
Phone Number * ### - ### - ####
I prefer to be contacted by
email phone either
I would also like to make a donation of $x.xx (not required)
Area(s) of Interest? *
Silent Art Auction Studio Tours Buses Parking Other

check all that apply
Availability *
Sun, May 20 MORNING Sun, May 20 AFTERNOON Sun, May 20 EVENING I am available ALL weekend I can help BEFORE Art Walk Weekend I can help AFTER Art Walk Weekend

Check all that apply
Each volunteer shift will be 4 hours. How many shifts would you like to work? *
Have you been a Venice Family Clinic staff member or volunteer in the past two years? *
Yes No
Some tasks require heavy lifting and a lot of walking. Are you comfortable with this type of assignment?
Yes No
Do you have any special needs, requirements or abilities?
Is there another person or group you'd like to be assigned to volunteer alongside? If yes, please include their full name(s) below.
Anything else you would like to share on this application?
Do Not Fill This Out

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