Katalusis Foundation

The Katalusis Foundation welcomes you to become a Katalyst, an agent of change, in our most distressed communities by serving as a volunteer or intern. If you are interested, please fill-in the online form. If you have additional questions contact volunteer@katalusis.org

First Name*

Last Name*

Residential Address:

Street address 1*

Street address 2

City*

State*

Zip code*

Mailing Address:
(if different from residential)

Street address 1*

Street address 2

City*

State*

Zip code*

Home Phone Number

Alternate Phone Number

E-mail Address*

Occupation

Age

How did you hear about Katalusis?

Tell us about yourself

Gender

Which number would you prefer we use to contact you in person

When can we contact you about your participation

Do you have children

Yes

	Would you like to be on the Katalusis e-mail list for announcements, newsletters, and other electronic correspondence?

	Would you like to be on the Katalusis mailing list for brochures, reports, and other Katalusis literature?

How would you like to be involved with Katalusis (check all that apply)?
	Volunteer for fundraising events
	Volunteer instructor for Delta Academy
	Volunteer for foundation administration/infrastructure
	Partnering organization with Katalusis