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Group Volunteer Request Form
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* Required
Contact Information
Group Leader Name
*
Your answer
Organization Name
*
Your answer
Organization Address
*
Your answer
City, State, Zip
*
Your answer
Phone Number
*
Your answer
Fax Number
Your answer
Email Address
*
Your answer
Number of Youth
*
(ages 17 and younger)
Your answer
Age Range of Youth
Your answer
Number of Adults
*
Your answer
Date Request
First Choice Date
*
MM
/
DD
/
YYYY
Second Choice Date
MM
/
DD
/
YYYY
Third Choice Date
MM
/
DD
/
YYYY
Time of Arrival
*
Time
:
AM
PM
Time of Departure
*
Time
:
AM
PM
Service Work Request
What kinds of work will your group feel comfortable doing?
*
(please check all that apply)
Light outdoor garden work kneeling (e.g. weeding)
Light outdoor garden work standing (e.g. watering)
Moderate outdoor garden or construction work
Standing work in green house (e.g. planting seeds)
Moderate lifting (less than 30 pounds)
Other:
Required
If any members of your group have special needs (e.g. wheelchair, etc.) please let us know here:
Your answer
Please list any other special requests here:
Your answer
Initial here that you have read and agree to the Group Service Day Policies listed on our website:
*
Your answer
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