Name:
Address:
City:
Zip Code:
State:
Home Phone:
Work Phone:
Cell Phone:
E-mail Address:
If Student, name of school:
Please list any experiences you have (volunteer, paid or education), and  resources (contacts, space, etc.)  that may be helpful in volunteering with H.A.L.O.:
Do you currently have pets?
How many?
What Type?
What days/times are you available to volunteer?:
Name:
Date:
What type of volunteer Opportunities are you interested in?
Please contact me with more information regarding Fostering and/or Volunteering
DOB (MM/DD/YYYY):
Are you in need of hours for school or court order community services hours? If so please let us know what the hours are needed for, how many hours are needed and when they need to be completed by: