CWS

24-Hour Crisis
Line
(252) 638-5995

If you are interested in becoming a Coastal Women's Shelter Volunteer, please fill out the form below. Please be sure to fill out all fields that apply to you.

Personal Information

First Name

Last Name:

Street Address:

City:

State:

Zip Code:

Home Phone:

Daytime Phone:

Email Address:

Occupation:

Employer:

Experience

Please explain briefly why you are interested in becoming a CWS volunteer; and how you heard about the volunteer opportunities available through CWS:

Please list the experiences you have that might enhance your ability to serve as a volunteer:

How often would you like to volunteer with CWS?

Once a week
About twice a month
About once a month
On occasion, when there is a special need

Please identify days and times when available:

Education, highest level earned:

Do you have any medical problems that would prevent you from lifting or carrying?

If yes, please explain:

Have you Ever been convicted of a crime?

Yes

If yes, please explain:

References:

Reference 1

Name:

Address:

Phone Number :

Relationship:

Reference 2

Name:

Address:

Phone Number :

Relationship:

Reference 3

Name:

Address:

Phone Number :

Relationship: