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VOLUNTEER INFORMATION SHEET

Women's Cancer Resource Center
4604 Chicago Ave. So., Minneapolis, MN 55407
Phone: 612-822-4846 or 1-877-892-6742
Fax: 612-822-4784
E-mail: wcrc@wcrcmn.org

Name Date

Address Daytime Phone

Evening Phone

Do you have or have you had cancer? Yes No

If so, what kind?

Would you be on a referral list if a woman would like to speak with you individually about your experiences or to get support? Yes No

Languages spoken other than English

Skills and Interests: Please check all areas that interest you.

Office
typing/word processing
bookkeeping
organizing/filing
other

Fundraising and Events
networking
grant writing
research
special events
other

Professional/Service
law
accounting
other

Community Outreach
public speaking
telephoning
sign language
advertising/media
other

Counseling
information/referral phone line
support group facilitation
advocacy
individual counseling
grief counseling
other

Information
newsletter
resource library
research issues
other

Activism
Speakers Bureau
letter writing
plan conferences

Please return the completed Volunteer Information Sheet to the Women's Cancer Resource Center at 4604 Chicago Ave. So., Minneapolis, MN 55407 by mail, or fax to 612-822-4784, or e-mail to benita@wcrcmn.org.