Volunteer!

Name*

First Last

Email*

Phone*

Birth Year*

Address*

Street Address Address Line 2 City State ZIP Code

Are you currently a student?*

Are you comfortable lifting 40 pounds?*

Yes
No

Languages Spoken*

How did you hear about our program?*

Friends/Family
Lorraine's Website
Facebook
Newspaper
MassLive
Internet Search
Other
Guest of Lorraine's Pantry & Soup Kitchen
School

Do you have any special considerations - medical or physical - that we should be aware of?*

Additional Comments*

Let us know what agency/college/major/or general info that we could use to place you in a volunteer position

Emergency Contact Info

Emergency Contact First and Last Name*

First Last

Emergency Contact Relationship*

Emergency Contact Phone Number + Area Code*

Community Service

Do you hope to fulfill a community service requirement?*

If for community service, number of hours needed a week?*

If for community service, by when?*

*Requests to volunteer in short timing may not always be possible, as the facility must plan ahead and schedule teams regularly.

Availability

Groups, please pick the day of the week and time of most interest.

Monday*

9:00 am -12:00 pm
12:00 pm - 3:00 pm
3:00 pm - 6:30 pm
All Day
Not Available

Tuesday*

9:00 am -12:00 pm
12:00 pm - 3:00 pm
3:00 pm - 6:30 pm
All Day
Not Available

Wednesday*

9:00 am -12:00 pm
12:00 pm - 3:00 pm
3:00 pm - 6:30 pm
All Day
Not Available

Thursday*

9:00 am -12:00 pm
12:00 pm - 3:00 pm
3:00 pm - 6:30 pm
All Day
Not Available

Friday*

9:00 am -12:00 pm
12:00 pm - 3:00 pm
3:00 pm - 6:30 pm
All Day
Not Available

Would you like a regular weekly shift?*

Yes
No
Maybe

Preferred Service Area*

Chef
Server
Pantry Worker
Dishwasher
Truck Assistant
Administrative
Housekeeping

You can choose more than one (Please note: Truck Assistant is mornings and involves picking up donations from donors which requires heavy lifting)

Weekend and/or After Hours Event Staffing*

On occasion we have events on weekends, and/or after hours, such as our 5K, Golf Tournament, Food Drives, etc...

Yes
No
Maybe

Commitment and Consent

Commitment*

Lorraine's Soup Kitchen & Pantry (LSKP) depends on it's volunteers in the same manner in which it depends on paid staff. Therefore, I understand that by committing to a shift, I will honor that commitment in the absence of an emergency or sickness only. If I become aware of a conflict with my commitment to the organization (vacations, doctor appointments, work, kids' school vacations, etc.), I will notify the Operations Manager with a minimum of a week's notice.

Yes
No

Confidentiality*

I understand that as a volunteer, it is important that I respect the confidentiality of clients of Lorraine's Soup Kitchen & Pantry (LSKP). Any information I may have in relation to LSKP clients will remain confidential.

Yes
No

Consent*

I hereby consent to the participation in interviews, the use of quotes, and taking of photos or videos for media marketing purposes.

Yes
No

Electronic Signature (First and Last Name)*

Date*

Untitled

Opportunities	Approximate Hours
Pantry Worker	9:00 am – 2:00 pm (as needed)
Housekeeping	9:00 am – 2:00 pm (as needed)
Chef	12:00 pm – 4:30 pm (as needed)
Server	4:30 pm – 6:30 pm
Dishwasher	4:30 pm – 6:30 pm
Truck Assistant	9:00 am – 2:00 pm
Administrative	9:00 am – 2:00 pm (as needed)

Lorraine’s Soup Kitchen

170 Pendexter Avenue Chicopee, MA 01013

(413) 592-9528

Volunteer Opportunities

*Requests to volunteer in short timing may not always be possible, as the facility must plan ahead and schedule teams regularly.

*Hours adjustable per the needs of volunteers as well as soup kitchen.

Donations needed!

Lorraine’s Soup Kitchen 170 Pendexter Avenue Chicopee, MA 01013 (413) 592-9528

Volunteer!

Volunteering is one of the many ways you can take action!

Volunteer Opportunities

*Requests to volunteer in short timing may not always be possible, as the facility must plan ahead and schedule teams regularly.

*Hours adjustable per the needs of volunteers as well as soup kitchen.

Donations needed!

Lorraine’s Soup Kitchen

170 Pendexter Avenue Chicopee, MA 01013

(413) 592-9528