DOUA MENTOR/VOLUNTEER INTERVIEW FORM
Please fill out this form and submit it .
Thank you and we look forward to working with you in our DOUA program.
fields marked with an * are mandatory
PERSONAL INFORMATION
*
Name:
*
Address:
*
City:
*
State/Province:
*
Country:
*
Zip/PostalCode:
*
Phone:
*
Email:
*
What days/times are best to contact you?
Which Instant Messenger Service do you use?
AIM
Buddy Name?
Yahoo
Buddy Name?
MSN
Buddy Name?
Other
Name of service.
Buddy Name?
EBAY and RELATED ONLINE ACTIVITY INFORMATION
*
eBay user ID:
eBay user ID?
(Please include all registered ID's)
*
How did you find DOUA?
*
What is your DOUA Training Center ID? (if you don't have one please register for one now by
clicking here
)
*
In what capacity would you like to assist DOUA?
Mentor
Volunteer
Quiet Supporter
Additional comments: