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Helpline: 24/7 Call or Text 904.225.9979 All our services are free and confidential. Admin: 904.491.6364

If you have any questions about becoming a volunteer please reach out to the members of the Community Engagement Team.

Lisa Rozier (Community Engagement Director) - 904-432-3470

Kaylee Duenas (Community Engagement Coordinator) - 904-431-9948

Both can be reached via email at info@micahsplace.org

First name*

Last name*

Address*

Birth Date*

Month

Day

Year

Email*

Phone Number*

What is your education level?

High School/GED

Some College

Associates Degree

Bachelor's Degree

Graduate Degree

Trade/Vocational School

If you are volunteering as part of a work program, what are your hour requirements?

Emergency Contact*

Phone Number*

Are You Interested in Working Events?

Which Store Would You Prefer?*

If Volunteering for the store what section would you prefer?

Do You Have Any Volunteer Experience? If Yes, Please Describe.*

Are you needing to collect volunteer hours for anything specific?*

What days are you available?

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

From what time are you available?

Time*

Time

:HoursMinutes

To what time are you available?

Time*

Time

:HoursMinutes

What is your T-Shirt size?

Signature*

Signature field is empty.

Date

Month

Day

Year

Micah's Place

Nassau County Florida's only Certified Domestic Violence Center. Our mission is to provide safety and support to those experiencing violence and raise awareness regarding it's cause, prevelance and impact.

Email: info@micahsplace.org

Phone: 904-491-6364

Registered Charity: 59-3675485

P.O. Box: 16287 Fernandina Beach FL, 32035

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