Date:        

Last Name:        

First Name:        

Address:        

City:        

State:        

Zip Code:        

Daytime Phone Number:        

Evening Phone Number (optional):        

E-Mail Address (optional):  

Birth Date (Optional):  

By checking this box, you affirm that you are 18 years old or older:

Special Qualifications (e.g., education, languages, training, experience, interests, hobbies, etc.):

 

Organizational Affiliations (e.g., Lions Club, church membership, etc.):

 

Employer:

Occupation:

Choose as few or as many as you like.  Training is available for technical roles.

Creating custom-recorded printed material for individual clients

Technical Assistance: radio engineering, tape dubbing, audio production

Reading or producing audio books for radio broadcast

Repairing or maintaining radios and other equipment

Reading magazines or other periodicals for weekly radio broadcast

Live weekly one-hour radio broadcasts of local newspapers

Substituting for radio newsreaders and/or recorded program readers

Basic office support (e.g., filing typing, postal preparation, etc.)

Performing listener surveys by telephone

Public Speaking on behalf of Taping For The Blind

Fundraising

Writing, editing and producing newsletters, brochures and other publications

Audio description for live theater, movies, museum exhibits and special events

Other, please specify:

Preferred Times to Volunteer:

Weekday morning

Weekday afternoon

Weekday evening

Weekend morning