Volunteers In
And
Ability Survey
Please
complete this survey to assist in determining your gifts and interests. Please print.
YOU ARE
NEEDED!!
Name:
Address:
City,
Age (Check One):
Under 18_____ 18-25_____ 25-45____ 45-60____ 60 and Over ____
Phone Numbers: Daytime _________________ Evening _____________
Cellular _________________ Fax __________________
E-Mail Address:
Please circle appropriate answer to the following
questions:
I (Have / Have Not) completed VIM Team Leader Training.
I (Have / Have Not) completed Basic Disaster Response
Training.
Below are examples of skills, please check next to skills you have (if you are a professional or licensed in a particular skill, please indicate with P or L in box):
Construction |
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Architect |
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Building Contractor |
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Surveyor |
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Building Consultant |
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Security Consultant |
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Carpentry |
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Electrician |
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Heating/Cooling |
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Plumbing |
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Roof/Spouting |
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Landscaping |
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Brick/Block Layer |
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Concrete Work |
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Paving |
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Heavy Equip. Op. |
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Dry Wall Hanging CDW |
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Dry Wall Finishing |
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Plastering |
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Painting |
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Draperies |
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Flooring |
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Insulation |
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Glass/Glazing |
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Construction Helper |
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Automotive |
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Auto Repair
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Semi-truck Driver
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Medical |
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Physician
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Nurse Practitioner
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Nurse
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Dentist
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Optometrist
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Pharmacist
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Dental Hygienist
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Therapy |
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Signing for the Deaf
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Braille/Speech
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Hearing Therapy
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Occupational/ Physical Therapy
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Business |
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Administrative
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Accounting
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Bookkeeping
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Business Mgmt.
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Computer Repair
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Computer Operator
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Computer Programmer
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Computer Consultant
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Lawyer
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Secretary
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Videographer BVD
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Teaching |
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Teaching Youth
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Teaching Children
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Tutoring
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Preschool
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Day Care
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Music
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Puppets/ Clowning
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Crafts
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Canning/ Food Prep.
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Sewing/ Tailoring
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Gardening/ Agriculture
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Nutritional Planning
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Household Budgeting
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Weaving
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Other Skills |
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Stain Glass Repair
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Organ Repair
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Furniture Repair
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Door/ Hardware Repair
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Electronics Repair
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Welding
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Metal Work
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Steeple Jack
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Cook/ Meal Prep.
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Other (please describe) |
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Other Construction
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Other Automotive
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Other Medical
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Other Therapy
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Other Business
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Other Teaching
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Please select the most desirable months of the year to serve as a volunteer:
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JAN |
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FEB |
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MAR |
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APR |
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MAY |
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JUNE |
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JULY |
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AUG |
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SEPT |
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OCT |
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NOV |
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DEC |
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Please select the most convenient days for you to serve as a volunteer:
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MON |
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TUES |
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WED |
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THURS |
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FRI |
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SAT |
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SUN |
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Would you prefer to serve (check all that apply):
Local Volunteers In
Please list any foreign languages that you are fluent in:
Do you have any physical limitations?
Would you like to be informed of future trainings?
Volunteer In Missions _____ Disaster Response _____
Please mail completed form to: Kansas East Conference UMC
Volunteer
In Missions
Or E-mail to: kseastvim@yahoo.com