First Name:
Last Name:
Daytime Phone Number:
Evening Phone Number:
Where did you hear about us:	Heard about We Care volunteering from a speaker Read about it in print advertisements Received a brochure Word of Mouth Learned about it through my civic organization Referral service such as Volunteers of America Other
Volunteer hours:	0-1 per week 1-3 per week 3-5 per week 5-7 per week More than 7 or as needed
Areas of Interest:	Patient Visits and Friendship Running Errands for Patients Fundraising and Events Speaking to the community Marketing and Advertising Music and Art Therapy Bereavement Group Assistance Music and Art Therapy Open to Any Opportunity