Book Day Volunteer Questionnaire Question Title * 1. Volunteer first and last name: Question Title * 2. Phone Number: Question Title * 3. E-mail address: Question Title * 4. Please indicate preferred Book Day venue. (Specific venue locations TBD) 1st Choice 2nd Choice 3rd Choice 4th Choice 5th Choice Bronx Bronx 1st Choice Bronx 2nd Choice Bronx 3rd Choice Bronx 4th Choice Bronx 5th Choice Brooklyn Brooklyn 1st Choice Brooklyn 2nd Choice Brooklyn 3rd Choice Brooklyn 4th Choice Brooklyn 5th Choice Manhattan Manhattan 1st Choice Manhattan 2nd Choice Manhattan 3rd Choice Manhattan 4th Choice Manhattan 5th Choice Staten Island (Ferry Terminal) Staten Island (Ferry Terminal) 1st Choice Staten Island (Ferry Terminal) 2nd Choice Staten Island (Ferry Terminal) 3rd Choice Staten Island (Ferry Terminal) 4th Choice Staten Island (Ferry Terminal) 5th Choice Queens Queens 1st Choice Queens 2nd Choice Queens 3rd Choice Queens 4th Choice Queens 5th Choice Question Title * 5. Please indicate preferred shift start time. Please let us know if you can work more than one shift or are free to work the entire day. First Choice Second Choice Third Choice 7am-9:30am 7am-9:30am First Choice 7am-9:30am Second Choice 7am-9:30am Third Choice 9:15am-12:15pm 9:15am-12:15pm First Choice 9:15am-12:15pm Second Choice 9:15am-12:15pm Third Choice 12:00pm-3:00pm 12:00pm-3:00pm First Choice 12:00pm-3:00pm Second Choice 12:00pm-3:00pm Third Choice Other (please specify) Question Title * 6. Please choose a volunteer orientation session: March 11: 1:00-2:30pm March 11: 7:00-8:30pm March 13: 7:00pm-8:30pm Other (please specify) Question Title * 7. Please list an emergency contact name and phone number: Question Title * 8. Do you have any allergies or health restrictions that we should be aware of? If yes please specify below. Yes No Please specify Question Title * 9. Do you have a preferred doctor or hospital? Yes No Please specify Question Title * 10. If you're not available to help on March 17 but still want to pitch in we'd love to have you come by the Center on any of the dates below. Please select any/all dates that work for you and indicate specific times in the field below. Volunteer shifts will begin at 11am and end about 6pm with extended hours on the 11th and 13th. These shifts are also open to day-of volunteers as well. The more the merrier! Monday, March 10 Tuesday, March 11 Wednesday, March 12 Thursday, March 13 Friday, March 14 Please share any specific time requests Done