Loaves & Fishes Centers, Inc. Volunteer Registation Form

Valentine-A-Gram
Volunteer Driver Sign-up Form

Routes take about 2 hours and pick up times are scheduled between 8:00 – 10:30 a.m.

To volunteer to deliver Valentine-A-Grams on Tuesday, February 14, 2012, please fill out the following information:

Personal Information:
First Name:
Last Name:
Phone Number:
Email Address:
Confirm Email Address:
Date of Birt h (MM-DD-YYYY):

Mailing Address:
Address:
City / State / Zip:

Volunteer Information:
Have you already volunteered with Loaves & Fishes Centers on or after July 1, 2011?
Your preferred pickup location:		(view map of pickup locations)
Is there a special geographic area you prefer to drive? (We will do our best to accomodate your request)

Would you like to receive future emails from Loaves & Fishes Centers?

Additional Volunteers:
Will you be bringing any additional volunteers with you?		Yes No