Venturing Activity Interest Survey

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Instructions:
Each year our Venturers need adult volunteers to serve as Advisors, program consultants, and helpers with
transportation, chaperoning, counseling, and planning.
We would like to know in which areas of interest, hobbies, or contacts you would be willing to help our Venturers.
If they decide to call on you for help, an appointment will be made with you well in advance.
Thank you for your willingness to assist our Venturers.

Date: *

YYYY

Name: *

Address, City, State, Zip *

Phone (mobile, home, work) *

Occupation *

Position *

Memberships: List your clubs, associations, fraternal groups, etc. *

Contacts: Please list people you would be willing to ask to share their careers, hobbies, or skills: *

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