2017 Citizen Corps New Volunteers
Thank you for your interest in volunteering with the Citizen Corps of Delaware County (CCDC). Please complete this form and your information will be forwarded to our Coordinator, Ed Kline. As new Citizen Corps Orientation classes are scheduled you will be notified by e-mail and have the opportunity to attend. You may also receive notification about other upcoming training and events prior to completing your orientation. This is to allow you to participate and get to know some of our other volunteers. If you have any questions or concerns please feel free to contact Ed Kline directly at klineE@co.delaware.pa.us or by calling 215-439-1407. Be sure to check out our web page at www.delcocitizencorps.com and look for us on Facebook and Twitter.
First Name *
Please enter your first name
Your answer
Last Name *
Please enter your last name.
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E-mail Address *
Please enter the e-mail address you would like us to contact you on.
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Confirm E-mail Address *
Please re-enter the same e-mail address.
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Home Phone Number
Please enter your home phone number without any dashes (6105551212).
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Cell Phone Number
Please enter your cell phone number without any dashes (6105551212).
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Current Street Address *
Please enter your current street address.
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Current City *
Please enter your current city of your residence.
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Current State *
Please choose the state you live in.
Current ZIP Code *
Please enter your current 5 digit ZIP code.
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Drivers License Number *
Please enter your driver's license number or state ID number
Your answer
Driver's License State *
Please choose the state your driver's license is from.
Are you interested in a particular sub group within Delco Citizen Corps?
There are several subgroups included in Citizen Corps. But you do not need to identify directly with any of them, but many volunteers do.
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