Farmhouse Friends

Full Name *

First Name

Last Name

Phone

or Guardian/Support Contact

(###)

###

####

What days would you like to volunteer?

(Choose all that apply - 9:00AM to 12:00PM only)

Monday

Tuesday

Wednesday

Thursday

Have you ever worked with farm animals before?

Yes

No

Are you scared of animals?

Yes

A little

No

Are you comfortable being around large animals?

(like horses, cows, or pigs)?

Yes

No

Maybe

Will you be coming with a job coach, support person, or caregiver?

Yes

No

Do you need help with communication, instructions, or mobility while working?

Yes

No

Name

First Name

Last Name

Phone

(###)

###

####