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Behavioral Health Interventions of Greater St. Louis
"Come talk to Us"
BHI Volunteer Application
Please fill out our volunteer form
First name:
Middle Initial:
Last name:
Home Address:
Apt#,Suite #,etc.:
City.:
State:
Province:
Postal Code:
Home Phone:
Cell Phone:
Email:
What days you would like to volunteer:
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Please select your preferred hours:
AM
PM
Are you over 18 years old?
Yes
No
Gender?
Male
Female
Would you like to recieve email communications from Behavioral Health Interventions of Greater St. Louis?
Yes
No
When is your birthdate?
:
What company do you work for? (Optional)
Company name:
What is your occupation? (Optional)
Occupation:
How did you hear about us?
Television
Newspaper
Radio
Internet
Friend
Other
Please check the types of tasks that you are interested in
Assist in Program Activities
Assist with Community Social Support Visits
Assist with Transportation
Assist with Special Events
Assist with Clerical Support
Other
Does Not Matter
What specific times are you available during each day of the week?
Monday
Select a Start time:
Select an End time:
Tuesday
Select a Start time:
Select an End time:
Wednesday
Select a Start time:
Select an End time:
Thursday
Select a Start time:
Select an End time:
Friday
Select a Start time:
Select an End time:
How would you describe your motivation for volunteering with us?
I want to contribute to the community
Would like to develop new skills
Would like to obtain a sense of acheivement
Interested in developing new interests and hobbies
The opportunities to develop new experiences
I like meeting new people
Interested in communicating a message to my employer, teachers,friends,and family etc.
Other motivations, please see explaination below
Please provide a detailed explaination of your response in the space provided below
Come Show Us A Thing Or Two!!
Thank you for your interest in voluteering with Us!
Come Show Us "A Thing Or Two"!
