DO-IT Volunteer Application/Information Form

Name:___________________________________________ Date:______________  

Address:____________________________________________________________
        street address          city          state          zip

Home phone:______________________  Email address:___________________

Profession/Employer (if applicable):________________________________

Work phone:_________________________________________________________


Skills: Overall, describe how you would like to contribute to the DO-IT Program.

       ________________________________________________________________________
            
       ________________________________________________________________________

       ________________________________________________________________________

       ________________________________________________________________________

       ________________________________________________________________________


Availability: Indicate when you are available to volunteer and for what types of activities.
       ____ DO-IT Events
            ____ help in DO-IT exhibits at the following conferences
                 ____     UW Health Sciences Open House
                 ____     UW Engineering Open House
                 ____     other
            ____ organize DO-IT event in your area (e.g. arrange a get-together,
                 career shadow for a day, field trip to local business, educational
                 event)
            ____ chaperone field trips during school year
            ____ sponsor a disability awareness presentation in your business, 
                 school, or community
            ____ speak at DO-IT disability, computer, or related workshops
            ____ help design and implement a DO-IT workshop,
                 topic:_______________________________________________
  
       ____ Summer Study Programs (July/August)
            ____ chaperone extra-curricular events, ___evenings___weekends
            ____ help in computer lab
            ____ assist in science lab
            ____ help with meals, snacks and errands
            ____ teach (topic:____________________________________________)
            ____ other____________________________________________________
            Preferred work hours and total number of hours_____________________
  
       ____ Office Work (mailings, filing, word processing)
            Preferred dates/times______________________________________________
  
            ___________________________________________________________________

Please use the rest of this sheet to provide additional information and comments.
Return the completed form to:

DO-IT
University of Washington
Box 354842
Seattle, WA 98195-4842
doit@u.washington.edu
http://www.washington.edu/doit/
206-685-DOIT (3648) (voice/TTY)
888-972-DOIT (3648) (toll free voice/TTY)
206-221-4171 (FAX)
509-328-9331 (voice/TTY) Spokane

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