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Name (First, Last)
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Email
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Cell Phone Number
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What languages do you speak?
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English
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What is your ZIP code?
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Do you have reliable transportation?
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Are you over the age of 60?
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Have you had fever or flu-like symptoms in the last week?
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I would like to volunteer for... (please select all that apply)
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Meal Distributions
Hygiene/Medical Donations
Veggie Farm Volunteer (Varying days)
Other
Are there any other ways you would like to volunteer that aren't listed above? If not, please write 'N/A' in the response below.
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Do you have medical/hygiene resources to donate? If so, please list them below {Optional].
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How did you hear about us?
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Home
Staff
Mutual Aid Programs
Volunteer
Donate
Contact