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Volunteer Form

Volunteer's Name:*
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Address:*
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City:*
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State:*
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Zip:*
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Email:*
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Phone:*
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Date of Birth*
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Education Information:*
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Current Occupation:*
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Do you possess a fingerprint clearance card?*
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Tell Us About Yourself:*
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What's On Your Bucket List?
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Hobbies, Skills, Interests:*
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What in life are you most passionate about?*
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Do you have any specific experience in working with terminally ill Seniors?*
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If yes, please explain:*
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Do you have any medical training or background?*
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If yes, please explain:*
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We have many opportunities available for volunteering with our foundation which include working directly with our terminally ill seniors in granting wishes,indirectly in assisting with the many tasks associated in granting wishes, community outreach and fundraising opportunities. It is important to us that your time, talent and passion be purposely matched to create a healthy and positive experience for all.

What area do you feel you would be best served?*
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Amount of time willing to donate to Bucket List Foundation*
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(For example 5 hours/week, 1 event/month)

How did you find out about Bucket List Foundation?*
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We know there are many charitable organizations to which you could donate your time and resources. What motivates you to volunteer with Bucket List Foundation?*
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Please provide 3 references:

Name:*
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Phone:*
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Email:*
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Name:*
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Name:*
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Email:*
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Our Mailing Address:

Bucket List Foundation
10810 N. Tatum #102-108
Phoenix, AZ 85028

A Registered 501(c)(3) non-profit organization

FED ID #45-4158479

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