Volunteer Registration Form

Akiramenai Homeless Outreach 3rd Saturday Volunteer Registration

Fill out the form to volunteer
Which 3rd Saturday is your outreach? *

Month Day Year
Date
Is this your first Akiramenai Homeless Outreach? *

Yes No
Name *

First Name・名前 Last Name/苗字
E-mail *
Phone Number

Area Code Phone Number
Age *
Organization
What are some skills you possess? *
Please Watch The 6 min Volunteer Briefing And Answer The Questions Below
Akiramenai Means? * .
Name one of the issues the homeless struggle with?blanks* .

One of the 4 causes of Homelessness in Japan is* .
What was the name of the homeless gentleman Pastor Marcel mentioned? *

Tanaka san Yoshi san Tanaka san Nishikawa san
(choose one) While on the outreach its very important to remember *

Have spare change To be quiet when approaching their houses Bring a donation
Refrain for which of the following? *

Visiting the homeless homes without Akiramenai Staff Taking pictures of the homeless faces Lending items or exchanging items None of the above
In what other way do you wish to volunteer?

Financially Toiletry/ Food/ Clothing Donations Tuesday Morning Volunteering All the above
We only have 3 available parking spaces. Will you drive? *

Yes No
How many cars total?
Please consider car pooling to the location
What do you hope to gain from the experience? *
Should be Empty:

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Akiramenai Homeless Outreach 3rd Saturday Volunteer Registration