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VOLUNTEERS’ DATA FORM We ask your indulgence as we enter the data collection phase of the National Volunteerism project and invite you to complete the accompanying questionnaire to enable a comprehensive listing and future volunteer placement. We appreciate your support and will be in touch with you as we ask for your support in helping to better serve our country.

NAME:

______________________________________________________

ADDRESS:

______________________________________________________

PARISH:

______________________________________________________

TELEPHONE:

______________________________________________________

EMAIL:

______________________________________________________

NATIONALITY:

______________________________________________________

MEMBERSHIP(S)

LOCAL NGO ‫ ڤ‬SERVICE CLUB ‫ ڤ‬CBO ‫ ٱ‬RELIGIOUS ‫ٱ‬ ACADEMIC ‫ٱ‬ INTERNATIONAL ORGANIZATION ‫ٱ‬ OTHER ‫ ٱ‬STUDENT ‫ٱ‬ Explain if other: _______________________________________ 1.

GENDER:

Male

2.

AGE (at last birth date):

‫ٱ‬

Female

Under 14 years 14-25 years 26-35 years 36-45 years 46-55 years 55- Older

‫ٱ‬ ‫ٱ‬ ‫ٱ‬ ‫ٱ‬ ‫ٱ‬ ‫ٱ‬ ‫ٱ‬


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