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TCHRC Volunteer Interest Form

Full Name

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Email Address

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Phone Number

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Preferred Pronouns

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Do you identify as someone with current or former substance use/dependency, street involvement, or someone who has experienced houselessness or participated in sex work?

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A

Yes

B

No

C

Prefer not to say

Are you familiar with responses to drug poisoning and Naloxone administration?

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A

Yes

B

No

C

I have experience responding

D

I am trained but have never responded

What areas of volunteering interest you the most or would you be willing to support & participate in?

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Packing kits for distribution (wound care kits, Naloxone kits, etc.)

Direct Service (working directly with participants to distribute supplies and provide support)

Participating in neighborhood cleanups

Helping with outreach events

Administration Support

Creating art

Other

Are you familiar with harm reduction supplies and how they are used?

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A

Yes

B

No

C

Somewhat

Do you have any previous experience in harm reduction work? If so, please explain. If not, please tell us why you are interested in harm reduction.

*

How did you hear about our program?

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