Tomball Emergency Assistance Ministries
Join our TEAM
Volunteer as an Individual
Volunteer your Group/School
Volunteer to fulfill Court Ordered Community Service
Volunteer to fulfill Other Community Service
Your Information
Name of the Group:
Name:
Address:
Zip Code:
Home Phone:
Cell Phone:
EMAIL:
Date of Birth:
Month
January
February
March
April
May
June
July
August
September
October
November
December
Day
Parent/Guardian:
Emergency Contact Information
Name:
Medical Information
Family Physician:
Health Problems:
Medications:
Physical Limitations:
Activities to Avoid:
Employment/School/Service Organizations Information
Are you currently employed?
Yes
No
Employer:
Does your employer offer contribution matching?
Yes
No
I don't know
Service Organizations you belong to:
Are you a student?
Yes
No
School Name:
Community Service Hours:
Start On:
Complete by:
Other referrals:
Charge:
Is your charge a?
Felony
Misdeameanor
Court Contact:
Your Schedule
When would you like to volunteer: (check all that apply)
Tuesday
Wednesday
Thursday
Friday
Saturday
As_Needed
Where would you like to volunteer: Resale Shop (10am to 5pm)
Yes
No
Food Pantry/Assistance Ministry (hours vary)
Yes
No
How long are you able to volunteer:
Partial days
All day
How often would you like to volunteer:
Daily
Weekly
Monthly
For Special Projects
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