Print this form, fill it in, and send it to:
CCHS (ATTN:VOLUNTEER SIGNUP)
PO Box 626
21 North Pitt Street
Carlisle, PA 17013


VOLUNTEER APPLICATION
Name____________________________________________________________________Date___________
Address______________________________________________________________________________
Phone: Home____________________ Business __________ Best time to reach you___________
Please share any of your skills, interests, employment or other volunteer experiences that you feel would contribute as a volunteer at CCHS (research projects, handicrafts, college degree, clerical/computer skills, etc.).
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Please check/circle volunteer opportunities on the back of this form in which you would be interested.
Times available: Weekly_____1st week_____2nd week_____ 3rd week ______ 4th week_______5th week_____
Monthly____
Days available:
Monday  10am-1pm ______ 1pm-5pm ______ 5pm-9pm ______
Tuesday 10am-1pm ______ 1pm-4pm ______
Wednesday 10am-1pm ______ 1pm-4pm ______
Thursday 10am-1pm ______ 1pm-4pm ______
Friday 10am-1pm ______ 1pm-4pm ______
Saturday 10am-1pm ______ 1pm-3pm ______

Special Events only ________Need flexible schedule _________ (Other Hours available by arrangement.)
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Please share any physical limitations that may influence your volunteer activities. _____________________________________________________________________________________________________________________
Birth Date (optional) ____________
In case of emergency while volunteering at CCHS, whom would you like CCHS to contact?
Name (and relation) __________________________________Phone _______________
Are you a Cumberland County Historical Society member? Yes ______No _____
How did you learn of the volunteer opportunities at CCHS? ____________________________________________
If you are under 18 years of age, give name of parent or guardian:__________________________________
Address ____________________________________________Phone_______________________
Reference (other than family member)
Name/Address ___________________________________________________________Phone____________
Your Signature _________________________________________________________________
(Rev: 1/2000)