*First Name:		*Last Name:
*Street Address:		*City:
*State:		*Zip:
* Email:		Phone:
Gender:		Birth Date mm/dd/yy:
Ethnicity (self-identify):		Employment:	Full-Time Part-Time Retired Unemployed Other
Please provide 2 references. If you have worked or voluntered for the Catholic church in Washington State, please include this as one of your references. No family members.
*Reference #1 (name, phone and email):		*Reference #2 (name, phone and email):
*Volunteer Interest (check all that apply):	ESL TutorInterpreter Refugee SupportCitizenship Tutor Office VolunteerOther   Other:	How did you hear about our program? (check all that apply):	Word-of-MouthParish Bulletin InternetOther Other:
Availability: Please let us know when you are available to volunteer.

Sunday:		Monday:		Tuesday:
Wednesday:		Thursday:		Friday:
Saturday:

In order to best match you with our program's needs, please answer the following questions. Your answers will help us to get to know you better.

*Why do you want to help refugees and immigrants?

*Do you have any special skills and/or interests you would be willing to share? (hobbies, languages spoken, professional expertise, etc.?)

*Describe any experiences you have had working with or helping refugees and immigrants.

*What have you enjoyed most and what have you enjoyed least in previous volunteer assignments?

Is there anything else you would like us to know?

*Required

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