Volunteer

The Refuge on Memorial Volunteer Interest Form

Thank you for your interest in serving with The Refuge on Memorial. We are grateful for your willingness to support our community. Please complete the form below so we can learn more about your availability and how you would like to serve. Once submitted, a member of our team will follow up with next steps and scheduling details.

The Refuge on Memorial Volunteer Interest Form

First Name *

Last Name *

Please Select Your Age Range *

Email *

Phone

Address

Street Address

City

State

Postal Code

Which days are you typically available to serve? *

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Which time slots are you available for? *

Morning Support (7:00 AM - 11:00 AM)

Mid-Day Programming (11:00 AM - 3:00 PM)

Evening + Intake (4:00 PM - 8:00 PM)

Late Support (8:00 PM - 12:00 AM)

Flexible Hours (7:00 AM - 9:00 PM)

Are you available to serve on Saturday or Sunday during these time slots? *

7:00 AM - 11:00 AM

5:00 PM - 11:00 PM

Flexible Hours 7:00 AM - 9:00 PM

How often are you interested in serving? *

Weekly

Bi-Weekly

Monthly

As needed

Which areas are you interested in serving in? (Select all that apply) *

Food Service (serving meals)

Food Preparation (preparing food off-site or bringing food)

Facilitating activities during the day

General support / whatever needed

Do you have any previous volunteer or work experience that may be helpful in this setting?

Do you have any additional skills, resources, or ways you’d like to contribute?

Please select one of the following *

I am a high school student

I am a college student

Neither

If the above is applicable, where do you attend?

Emergency Contact Name

Emergency Contact Phone Number

I understand that by submitting this form, I am expressing interest in volunteering with The Refuge on Memorial. I agree to communicate any changes in my availability and to follow all guidelines provided by the organization.

2220 Memorial Ave

Lynchburg, VA 24501

[email protected]