Dining Out For Life Ambassador Application

Dining Out For Life is on Thursday, April 29th, 2010. Thank you for your interest in volunteering for Dining Out For Life! Please fill out this application and we will contact you with more information.

To see a list of participating restaurants, please go to http://www.diningoutforlife.com/seattle/participating.

If you haven't heard from us or if you are having trouble submitting the application, please contact Tony at anthonyb@llaa.org.

All volunteer interviews and trainings take place at Lifelong AIDS Alliance, located in Capitol Hill at 1002 E Seneca St, Seattle, WA 98122.

Contact Information

First Name: *

Last Name: *

Address: *

City: *

State: *

ZIP Code: *

Phone Number: *

E-mail Address: *

Date of Birth: *

Volunteering Information

Please indicate your relationship to Lifelong: *

If you have been referred to volunteer by a friend, please indicate his/her name:

I am volunteering: *

If volunteering with a friend, both parties need to fill out the volunteer ambassador application online.

Name of volunteer partner:

Would you like to help out at Dining Out For Life headquarters on the day of the event?:

Previous Ambassadors

Have you volunteered as a Dining Out For Life ambassador before?: *

If yes, please indicate which restaurant(s) you have volunteered at:

If yes, would you like to volunteer at this restaurant again?:

Meal Assignment

Please indicate your first choice meal assignment: *

Please indicate your second choice meal assignment:

Are you available to work more than one shift?: *

Restaurant Assignment

Restaurant Type - First Choice: *

Restaurant Type - Second Choice:

Restaurant Size - First Choice: *

Restaurant Size - Second Choice:

Restaurant Location - First Choice: *

Restaurant Location - Second Choice:

Please choose a preferred training date (required for all new ambassadors):

Please choose a preferred interview date (required for all new ambassadors):

May we use your name in our publications?: *

May we use your photo in publications?: *

Please provide any information about yourself that could help us better place you in a volunteer assignment:

Have you ever plead guilty to or been convicted of any criminal offense?: *

If yes, please explain:

Additional Comments:

Please select: *

Yes, I have read and accept the terms and conditions of the Volunteer Agreement. I am aware that a criminal background check will be performed upon submittal of this volunteer application.

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