Heart Walk Volunteer Questionnaire
Please fill out the following questions regarding your interest in volunteering for the 2023 Kentuckiana Heart Walk. Once submitted, we will be in touch with you shortly.
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency contact information
*
Are you 18+?
*
Yes
No
Are you available at any of the times below?
*
Friday the 15th @ 10am-2pm
Saturday the 16th @ 6am-11am
Saturday the 16th @ 8am-1pm
Limitations, physical or otherwise:
*
Yes
No
Please provide details of your limitations:
*
Do you have any preferences for tasks, special requirements/needs, experience in events, etc.?
*
We will do our best to accommodate all preferences but cannot guarantee tasks prior to volunteer time.
Are you volunteering for service hours?
*
Yes
No
Are you registered for the 2023 Heart Walk? A link to register will be included on your confirmation email. All volunteers are required to register.
*
Yes
No
Submit
Should be Empty: