Volunteering Expression of Interest

Full name:

Mobile Phone: Your email:

What is your age? 16 and under17-3031-4546-6465+

How did you hear about Holdsworth?:

Which participant group interests you? Children 0 -5People living with a disabilitySeniorsCarers

Which activity interests you? Group social activitiesOne on one home visitsMeal DeliveryEventsAdministrationResearch ProjectsOther
Please Specify:

Interests / Hobbies: *We will use information to help match you to one on one visit participants or to introduce you in our newsletter.

How many hours a week would you like to volunteer? 1-23-66-910+

Volunteer Availability – Please indicate
Morning MondayTuesdayWednesdayThursdayFridaySaturdaySunday
Afternoon MondayTuesdayWednesdayThursdayFridaySaturdaySunday
Evening MondayTuesdayWednesdayThursdayFridaySaturdaySunday

Do you have the use of a car: YesNo