Contact Name First Last Email PhoneBest way to contact you?What are you inquiring about?I have a question/commentI want to volunteerI want to take a tourI want to request a speakerI want to become an Agency PartnerI have food to donateI want to know more about financial donationsI need helpQuestion/Comment:Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Birthday MM DD YYYY If your volunteer hours are required, please indicate who is requiring you to complete hours:CourtWorkfareSchoolChurchNot RequiredHow often would you like to volunteer?One-timeMonthlyWeeklyVariesWhat days of the week and time of day are you interested in volunteering? Monday (8-12) Monday (1-4) Tuesday (8-12) Tuesday (1-4) Wednesday (8-12) Thursday (8-12) Thursday (1-4) Friday (8-12) Friday (1-4) Past Occupations (Optional)Special interests or abilities (Optional)Working directly with clients, helping with administrative duties, fundraising, working with others, etc.Are you able to lift 40 lbs?YesNoDo you have any physical limitations?Is there anything you are unable or unwilling to do?Has your driver’s license ever been suspended or revoked in any state in the last three years?YesNoIf you answered Yes to the previous question, please provide a brief explanationEmergency Contact InformationName, Relationship, PhoneHow did you hear about volunteering at Weld Food Bank? (Optional)Agreement*I give Weld Food Bank full permission to copyright and/or use, reuse and/or publish and/or republish pictures or images of my volunteer time for the purpose of illustration, advertising, promoting or for any purpose Weld Food Bank deems appropriate, through any medium. I understand Weld Food Bank has the right to change or alter this material. I agree Is this for a business, church or other group?If so, what is the name of your group?How did you hear about us?Is this for a business, church or other group?If so, what is the name of your group?Date Time : HH MM AM PM How did you hear about us?Any special instructions regarding your venue, group, etc.?Name of your 501(c)3 nonprofitTown you/area you serveWhat services to you provide?Why do you want to become an agency partner?Town/area you are locatedWhat are you looking to donate?Do you need it picked up?Please provide a brief explanation of your inquiryPlease use the following links: Find Food Near You Access a Food Program Address: 1108 H Street Greeley, CO 80631 Phone: 970-356-2199 Fax: 970-356-2297