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Volunteer Step 1 of 4 25% Chaverim Of Queens & Great Neck ApplicationBasic InfoDate(Required) MM slash DD slash YYYY Your Name(Required) First Last Address(Required) Street Address City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Cell Phone(Required)Home PhoneYour Email Address(Required) Birth Date(Required) MM slash DD slash YYYY Jacket Size(Required)XSSMLXLXXL Chaverim Of Queens & Great Neck ApplicationScheduleWhat Position Are You Applying For?(Required) Responder Dispatcher Service Unit Monday Mornings Afternoons Evenings Night Shift Tuesday Mornings Afternoons Evenings Night Shift Wednesday Mornings Afternoons Evenings Night Shift Thursday Mornings Afternoons Evenings Night Shift Friday Mornings Afternoons Motzai Shabbos Evenings Night Shift Sunday Mornings Afternoons Evenings Night shift Vehicle Used To Respond:(Required)MakeModelPlate # Add RemoveMarital Status(Required) Married Single What Do You Do?(Required)(Choose All That Apply) Work Student In Yeshiva Other: Other:(Required)Employment Status:(Required)Please Include The Name Of Where You Work With Its Hours, Phone Number And Address:Student/Yeshiva Status:(Required)Please Include The Name Of Where You Learn With Its Hours, Phone Number And Address:Are You Affiliated With Another Organization?(Required) Yes No Please Select All That Apply:(Required) Hatzalah 5T Chaverim BK Chaverim Shomrim Shmira Misaskim Other: Other:(Required)Please ExplainWhere Do You Daven?Shul NameRabbi's NameRabbi's Contact InfoAre You Shomer Shabbat?(Required) Yes Mostly Working On It No Chaverim Of Queens & Great Neck ApplicationReferencesReference #1 Name: First Last Reference #1 Phone Number:Reference #2 Name: First Last Reference #2 Phone Number:Name/Unit Numbers Of Chaverim Members You Know: Chaverim Of Queens & Great Neck ApplicationExperienceIn Which Of The Following Do You Have Experience: Boosting A Dead Battery Changing A Flat Tire Car Lockouts House Lockouts Other Other:(Required)Do You Have Any Other Experience That Might Assist You On Chaverim Calls ? ie. Electrician/Locksmith/PlumberThis field is hidden when viewing the formBest Time To Call YouWhen is the best time for us to reach you via telephone?MorningsEarly AfternoonLate AfternoonEarly EveningThis field is hidden when viewing the formYour Previous EmployersPlease list your previous employers, the dates you worked and the position you heldEmployerDatesPositionPhone Add RemoveThis field is hidden when viewing the formTell Us About YourselfThis field is hidden when viewing the formUpload Your ResumeUpload your resume in .pdf, .doc or .docx formatAccepted file types: pdf, doc, docx, Max. file size: 25 MB. I the above mentioned verify that all information on this application is correct and that any equipment (ie. Tools or ID card) if ever the need will be returned at the request of a supervisor or coordinator of Chaverim Of Queens.(Required) I AgreeName(Required) Print Name Signature(Required)