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Volunteer Application

* Required Fields

First Name *
Last Name *
Address *
City *
State *
Zip Code *
County *
CWAG District (If Known)
Home Phone *
Work Phone
E-Mail Address


Please check the areas in which you are willing to volunteer for CWAG *

Madison Office * Throughout the state *
Clerical Assistance
Law Library Assistant
Training Center Assistant
Proofreading
Canada Rx Program
Medicare Integrity Project
 
Outreach: Hand out brochures at county/senior fairs
Media Volunteer - newspaper, radio, tv
Speakers Bureau - give community presentations
Medicare clerical volunteer
Lead District Volunteer
Statewide Volunteer Coordinator
Training Volunteers
Pro Bono Professional Services (Legal, Financial, Human Services)
Staff Booths at conventions, expos, trainings representing CWAG

 

What in your past community, civic, and work history leads you to
volunteer in the areas checked above? *

 

Other volunteer experiences:

 

Do you drive?  

 

Days of week, and times we may contact you: *

 

I would like to pledge to assist CWAG: *
hours per week
hours per month
hours - other
 
Please list schedule commitments, conflicts, and considerations:

 

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