Teleservice Volunteer Sign-Up Form "*" indicates required fields Contact InformationFirst Name*Last Name*Sobriety Date* MM slash DD slash YYYY Sign-up Date* MM slash DD slash YYYY Gender*Languages Spoken (Non-English)Email*Phone Number*Teleservice OpportunitiesAre you a returning volunteer?* Yes No Check the service opportunities that you would like to help with* TeleService (answering calls via your cell phone) 12 Step List Volunteer Special Needs (available to take a meeting to a person homebound or in a hospital) TeleService ShiftSundayI'm Not AvailableI'm Available AnymtimeMIDNIGHT – 8:00 AM8:00 AM – NOONNOON – 4:00 PM4:00 PM – 8:00 PM8:00 PM – MIDNIGHTMondayI'm Not AvailableI'm Available AnymtimeMIDNIGHT – 6:00 AM6:00 AM – 9:00 AM5:00 PM – 9:00 PM9:00 PM – MIDNIGHTTuesdayI'm Not AvailableI'm Available AnymtimeMIDNIGHT – 6:00 AM6:00 AM – 9:00 AM5:00 PM – 9:00 PM9:00 PM – MIDNIGHTWednesdayI'm Not AvailableI'm Available AnymtimeMIDNIGHT – 6:00 AM6:00 AM – 9:00 AM5:00 PM – 9:00 PM9:00 PM – MIDNIGHTThursdayI'm Not AvailableI'm Available AnymtimeMIDNIGHT – 6:00 AM6:00 AM – 9:00 AM5:00 PM – 9:00 PM9:00 PM – MIDNIGHTFridayI'm Not AvailableI'm Available AnymtimeMIDNIGHT – 6:00 AM6:00 AM – 9:00 AM5:00 PM – 9:00 PM9:00 PM – MIDNIGHTSaturdayI'm Not AvailableI'm Available AnymtimeMIDNIGHT – 8:00 AM8:00 AM – NOONNOON – 4:00 PM4:00 PM – 8:00 PM8:00 PM – MIDNIGHT 12 Step List VolunteerAble to receive Texting for a 12 step calls* Yes No Availability for 12 step calls*PhoneThis field is for validation purposes and should be left unchanged.
