Volunteer Status Change Form
Name
*
First Name
Last Name
I volunteer in - County
*
Martin
St Lucie
I volunteer in - Role
*
Administrative / Data Entry
Comfort Calls
Front Desk/Reception
IPU/Hospice House
Patient Visitor
Thrift Store
Treasured Pets
Stitcher/Blanket Maker/ Bear Maker
Events/Foundation
Other
Information to Change
New Phone Number
-
Area Code
Phone Number
New Email Address
New Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please note I will take time off from volunteering due to the following:
I am seasonal and leaving the Florida area as of the following date:
-
Month
-
Day
Year
Date
I am taking time off due to my health, family health concerns or death:
Please tell us approximately how long you plan to be gone.
I am taking time off for vacation and plan to return on the following date:
-
Month
-
Day
Year
Date
Submit
Should be Empty: