Volunteer Registration

 
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Sunday, April 22, 2018 · 1PM–4PM at the Oak Park Community 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 Regina Weiss at 248-837-8009 or at regina.a.weiss@gmail.com.


Name: *
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: