1.   Name               

  Street Address               City         Zip   

  E-mail

  Day phone         Eve phone         Cell phone

2.   Occupation

3.   Please describe your gardening interests, skills, hobbies:

4.   How did you learn about the Citizen Pruner program?

5.   Why do you wish to be a Citizen Pruner volunteer?

6.   Describe any previous volunteer experience(s). Please list organizations and when.

7. Describe any volunteer teaching experience(s):

8. What kinds of skills would you like to develop in this volunteer role?

9.   Volunteer roles that interest you:

  _____ Hands-on work – pruning, etc.

  _____ Program development (advising and assisting with program planning)

  _____ Organization support (organize events, group leader)

  _____ Marketing the program ) presentations, media outreach, exhibits)

  _____ Teaching and information sharing (volunteer instructor, writing materials)

10. Are you available for all training dates? _____ Yes _____ No, I will miss ________________________ (date).

11. Times available for volunteer work (please indicate hours/days of week):

  _____ 9:00-10:30 AM   _____ Afternoon   _____ 5:30-7:00 PM

  Preferred day of week: _____ M _____ T _____ W _____ Th _____ F _____ Sa _____ Su

12. Do you have a valid driver's license? _____ Yes _____ No

13. Do you require transportation assistance to fulfill your role as a volunteer? _____ Yes _____ No

14. Do you have any health or physical limitations that may affect your volunteer work? _____ Yes _____ No

  If yes, please explain:

15. In an emergency, notify:

  Name:                 Telephone:

  Address: