Date:

Name:

Address:

Phone:

Email:

Age (circle one): 0-17 * 18-29 * 30-39 * 40-55 * 56+

Occupation:

Location:

Schedule:

Are you familiar with Salvation Farms? YES NO
Salvation Farms is a group of local farmers, community members, and volunteers that harvest excess farm produce (gleaning) and donate crops to a variety of food service agencies.

Are you interested in getting involved or receiving more information?
YES NO

GET INVOLVED INFORMATION

Interest

(very low) 1 2 3 4 5 6 7 8 9 10 (very high)

Availability

Weekends:

Weekdays:

Interests: (gleaning, phone calls, fundraising events, mailings, spreadsheets, deliveries, etc.)

Skills/Gifts: (grant writing, cooking, nutrition, farming, leadership, teaching, etc.)

What attracts you to Salvation Farms?

How did you hear about Salvation Farms?

If you are interested in gleaning, do you have transportation? YES NO

Are you interested in delivering donations? YES NO
Would you want mileage reimbursement for deliveries? YES NO

Do you have children? YES NO
How many?

What ages?

Would they volunteer? YES NO

Previous Involvement and Educational Aspects:

Have you volunteered with Salvation Farms before?

If so, when and where?

What was your most memorable experience volunteering with Salvation Farms?

What did you learn through working with Salvation Farms?

What kinds of educational opportunities (workshops, classes, etc.) would you like to see Salvation Farms offer in the future?

Would you be interested in leading a class or workshop?

If so, on what subject?

Questions, comments, ideas:

Thanks! We hope to work with you soon!
Salvation Farms
813 Brook Road
Wolcott, VT 05680
802-888-5055
salvagedonation@yahoo.com
www.salvationfarms.org