Volunteer Registration

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Sunday, May 5, 2019 · 1PM–4PM at the Gillham Recreation Center

If you are interested in volunteering for the Tri-Community Coalition
Health and Wellness Fair, please fill out the form below. We appreciate your help!

If you have any questions, concerns, or difficulties with the registration form, please contact Tri-Community Coalition at 248-518-0853 or at tcc.hwfair@gmail.com.

Name: *
Phone Number: *
Phone Number:
Emergency Contact Name: *
Emergency Contact Name:
Emergency Contact Phone Number: *
Emergency Contact Phone Number:
I am interested in the following duties: *
Check all that apply.
I am interested in the following shift times: *
Check all that apply.
If you are a student, please check the box below and have your parent or guardian finalize this form. These volunteer hours can be used toward your required service hours for school:
Parent/Guardian Name:
Parent/Guardian Name: