Date

Personal Information

Name Preferred Name

Address City State Zip Code

Home Phone Work Phone CellPhone

Email Address Birth Date

Where do you prefer to be contacted weekdays between 8:00 AM and 4:30 PM? Contact Select One Home Phone Work Phone Cell Phone Email

Business and Professional Information

Are you currently employed, retired, in school, or other? Please explain if other.

Current or Most Recent Work Place

Work Address

Most Current Position and others held with this company

List previous workplaces and positions:

Community Involvment

What Community, Civic, Religious, or Professional Groups are you a member of?
Please underline if you are interested in inviting a representative from Minds Eye make a presentation at one of these groups.

Where do you currently volunteer?

Where have you previously volunteered?

Education/Special Interests

Education Level Completed Select One High School 2 Years of College 4 Years of College Masters + Degrees Attained/Pursuing

To which magazines or newspapers do you subscribe?

List any hobbies or outside interests

Where did you hear about volunteering for Minds Eye?

Projected Involvement with Minds Eye

How often do you think you would like to volunteer? Select One Once a Week Twice a Month Once a Month Other Other

When do you think you would like to volunteer? Select One Weekday Days Weekday Evenings Weekends

Please indicate which days best fit your schedule
Monday Tuesday Wednesday Thursday Friday Saturday Sunday

Comments regarding availability

Skills: Click all that apply

Advocacy HAM Radio Public Relations Bi-Lingual Mailings Public Speaking
Electrical Circuits/Wiring Marketing Working With Seniors

Minds Eye Information Service Volunteer Positions: Click all of interest

Book Sorter Check Equipment in Facilities Data Entry/Internet Fundraising Specialist Listener Outreach
Man Booth at Festivals Phone Work Producer Radio Repair Work Reading Recorded Reading Live
Solicitor for Event Donations

Fundraising Help: Can You Help Support Minds Eye by Doing Any of the Following?

Help Plan Beepball Volunteer at Beepball Attend Beepball

Help Plan Trivia Night Volunteer At Trivia Night Attend Trivia Night

Help Plan Soiree pour la Vue Volunteer at Soiree pour la Vue Attend Soiree pour la Vue

Help Plan Book Sale Volunteer at Book Sale Attend Book Sale

Support any of our events by

Pre-Event Promotion Decorating/Set Up Registration Table Clean Up

If you are also interested in volunteering with the National Shrine of Our Lady of the Snows, click the area that you are interested in, and we will forward your application to Diana Daab, Shrine Volunteer Coordinator.

Shrine Special Events Our Lady of the Snows Church Guild Center Exhibit

MAIL APPLICATION TO:
MINDS EYE INFORMATION SERVICE
9541 CHURCH CIRCLE DR.
BELLEVILLE, IL 62223-1000
618-394-6221
314-241-3400 Ext 6221
Minds Eye Information Service is a United Way Agency