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Legal Services of Southern Piedmont

*Name:
Preferred Name:
*Street Address:
*City:
*State:
*Zip:
*Work Phone:
Other Phone:
Fax:
Email:
Availability:	Monday  Tuesday  Wednesday  Thursday  Friday
Time of Day:	Morning  Afternoon  Both
Desired Start Date:
North Carolina Notary:	Yes  No
Computer Skills:	Microsoft Word  Microsoft Excel  Microsoft Access  Microsoft PowerPoint  Other
If other is checked, please explain:
*Please list any language skills, including level of fluency:
Please indicate your interest in working in one or more in the following areas:	Elder Law  Public Benefits & Health  Tax Matters  Employment Law  Assistance to non English- Speakers  Family Law  Housing Law  Immigration Law  Consumer Law  Immediate Needs & Special Projects
If Immediate Needs & Special Projects are checked, please specify:
Additional Information:	I am willing to visit elderly clients outside of the office
Why are you interested in volunteering for Legal Services of Southern Piedmont:
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