Volunteer Information Form

Name

Address

City, State, Zip

Phone

E-mail

AgeAdult (age 18 or older)Youth (age 12–17)

Availability

Delivery Days - Involves lifting, usually 90 minutesFirst Monday of each month, 8 AMThird Monday of each month, 8 AM

Open Pantry Days - Involves working with clientsTuesdays, 6:30–8:15 PMThursdays, 12–2:45 PMSaturdays, 9:30 AM–12:15 PM

Food Pick-up Days - May involve lifting, usually 90 minutesTuesdays, 10 AMThursdays, 10 AMFridays, 10 AM

How often would you like to be scheduled? There is no guarantee all requests will be granted. The Food Pantry Director has final decision based on the needs of the pantry.Every weekOnce a monthTwice a monthAs neededTo fulfill service hours for school

Have you volunteered at any other food pantry? If so, which one?

How did you hear about Lord of Glory Food Pantry?

Have you ever received food assistance from Lord of Glory Food Pantry?YesNo