Need-A-Break Services

Volunteer Registration To download a PDF version of the Volunteer Form for volunteer individuals, click here. To download aPDFd version of the Volunteer Form for volunteer professionals and companies, click here.
How did you hear about us?
Your full name:
Your date of birth:
Street address (include apt. or unit #):
City:
State:
Zip:
Phone number:
Cell phone number:
Email:
Fax:
My Skills are:
Listed below are some ways to volunteer with Need-A-Break Services. Please select the one you are most interested in.
	Volunteer periodically for special projects
	Volunteer 2-4 hours a week
	Provide discounted or donated auto repairs
	Provide discounted or donated home repairs
	Input data into a computer
	Load goods onto trucks
	Provide administrative services
	Coordinate gift baskets
	Other:

Have you ever participated in a volunteer project before?	Yes No
Year of volunteer project:
If yes please provide details of your project?

Do you have any friends that may also like to volunteer?	Yes No

First Contact Name.
First Contact Address:
First Contact Phone:

Second Contact Name.
Second Contact Address:
Second Contact Phone:

Would you be interested in being a Project Captain?	Yes No
(The Project Captain inspects and assesses the project, establishes a relationship with the client, and ensures the necessary materials and supplies are on hand and within budget.)

Please provide the name of your crew if you are part of one:

Most projects will be one-day events and Need-A-Break Services will supply you with a receipt for your year-end taxes.