Project Healthy Community's Volunteer Application for the After School Program
Project Healthy Community's After school program takes place Mon-Thurs. Mondays, Tuesdays, and Thursdays the program runs from 3:45-6:00PM and Wednesdays it runs from 2:45-5:00PM.
First Name *
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Last Name *
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Street Address *
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City *
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Zip Code *
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Telephone Number *
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Email Address *
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Date of Birth (MM/DD/YYYY) *
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Preferred Method of Contact *
Do you have any physical limitations? If yes, please explain.
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Highest level of education completed? *
Former Work/Occupation
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Most Recent Employer (optional)
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Which day(s) of the week are you available? *
Required
When can you begin? *
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How did you hear about us? *
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In an emergency, notify: *
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Volunteers hereby agree to serve program participants regardless of race, sex, creed or national origin, and uphold the mission and objectives of Project Healthy Community. Please sign below: *
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