PCASC Volunteer Interest Form
First Name:
*
Last Name:
*
E-mail:
*
Phone:
*
Address:
*
City:
*
State:
*
AL
AK
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip code:
*
What is the best way to reach you?
Email
Phone
What issues are you interested in working on?
Agriculture/Land rights
Art
Globalization/Trade Policies
Immigrants Rights
Labor/Worker's Rights
Media activism
Women/Gender
Youth
Other
What countries are you interested in learning about/organizing around?
Argentina
Bolivia
Brazil
Chile
Colombia
Cuba
Ecuador
El Salvador
Guatemala
Haiti
Mexico
Nicaragua
Venezuela
Other
What experience/skills would you like to contribute to PCASC?
Accounting
Advertising/Media
Databasing
Grantwriting
Graphic Design/Layout
Office Work
Translating
Web Design
Other
What experience/skills would you like to learn from PCASC?
Accounting
Advertising/Media
Databasing
Grantwriting
Graphic Design/Layout
Office Work
Translating
Web Design
Other
How many hours a month do you or would you like to volunteer for PCASC
1-5
5-10
10-20
More than 20
When are you available to volunteer?
Monday Daytime
Monday Evening
Tuesday Daytime
Tuesday Evening
Wednesday Daytime
Wednesday Evening
Thursday Daytime
Thursday Evening
Friday Daytime
Friday Evening
Saturday Daytime
Saturday Evening
Sunday Daytime
Sunday Evening
Please check off which Committees you are involved with/interested in getting involved with
Bolivarian Media Exchange
Comite Latino
Cross Border Labor Organizing Council
El Salvador/CISPES Committee
Venezuela Solidarity Committee
I don't know/I want to be a general volunteer
Would you be interested in attending a new volunteer orientation?
*
Yes
No