Participation Form
Be a part of the process and make your commitment count.  Adopt-A-School Day is a solely operated volunteer project, and every person can make a difference!

This is an online version of our volunteer participation form.  We ask that you please fill out all the fields by August 5, 2012.  

If you would still like to mail in your forms, you may do so at:  
Hawaii Jaycees
Adopt-A-School Day 2012 Forms
P.O. Box 23206 Honolulu, HI 96823-3206

If you would like to email us the forms, please email them to: info@adoptaschoolday.org

For additional questions or concerns, please feel free to contact info@adoptaschoolday.org and or 728-0799
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Name of Organization *
Website Address (if any) *
www.AdoptASchoolDay.org; if none, please type in none
Brief description of organization. *
The Hawaii Jaycees is a non-profit civic organization.  We are young leaders ages 18-40 whose goal is to build leaders through community service.
Primary contact information (Name, email, phone) *
Melanie Wong, melanie@gmail.com, 123-4567
Secondary contact (Name, email, phone) *
Patrick Tomiyasu, Pat@gmail.com, 123-4567
Name of School(s) *
W.R. Farrington High School, Iolani School, Kalihi Kai Elementary School
Primary contact information of the school *
Mrs. Nitta, Nitta@yahoo.com, 123-4567
Project Description *
Check one
Required
Birief description of project *
Our group will be working with Kalihi Kai Elementary School to beautify their campus by...
Estimated value of project ($ value) *
$100 paint, $50 paint brushes, $150 food for students; Total: $300
Date of Project *
Referred by (person/organization) *
Eve Epitome of Rising Phoenix Jaycees
Project coordinator agrees to waive any and all claims against the Hawaii State Jaycees' Adopt-A-School Day Committee, and/or any other persons/entities that are in any manner connected with the Hawaii Jaycees' Adopt-A-School Day project, from any and all damages or loss of personal property, or injuries (including death) that may occur before, during, or after the Hawaii Jaycees' Adopt-A-School Day events.  Participants assume all risks associated with this project. *
Yvette Lee (Online signature)
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