Volunteer Registration
This form is for those interested in Volunteering for the Free Dental/Vision Clinic & Diabetes Undone Seminar. 
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Email *
Name *
Address *
Phone Number (Cell) *
Phone Number (Alternate)
Male/Female *
Age Group *
12-17: Name of Adult Volunteering with you -        
Name of Adult: 
Languages I Speak Frequently *
Indicate Language if not listed. 
Language: 
Which Department would you like to lend your assistance? *
August 28, 2025 *
Required
August 29, 2025 *
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