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2. Name*
3. Email Address*
5. Address*
6. Phone Number*
8. Date of Birth*
   Date of Birth
9. Age*
10. Gender
12. Other Volunteer Work

    Do you currently volunteer for another agency or organization?

    1. Yes
    2. No
13. If yes, where?
15. Volunteer Interests

    Details on these programs (opens in a new tab)

    Check all that apply.

    1. Adopt-a-Street Snow Removal
    2. Bay Buddies
    3. Senior Center Volunteer
    4. Snow Angels
16. Good Neighbor Volunteer

    Check all that apply.

    1. Lawn Mowing
    2. Light Landscaping
    3. Leaf Raking
    4. Minor Outdoor Home Repair
    5. Garbage Can Duty
18. Snow Angels

    If you would like to volunteer for the Snow Angels program, we'll need some additional information. Please complete the Snow Angel Sign-Up. (opens in a new tab)

20. I am a student needing community service hours

    1. Yes
    2. No
22. Volunteer Availability: Weekday

    Check all that apply.

    1. Morning
    2. Afternoon
    3. Evening
    4. Anytime
23. Volunteer Availability: Weekend

    Check all that apply.

    1. Morning
    2. Afternoon
    3. Evening
    4. Weekend
25. Physical Condition*

    Do you have a physical condition that may limit your activities?

    1. Yes
    2. No
26. If yes, please describe
28. Emergency Contact Name*
29. Emergency Contact Phone Number*
31. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
33. Electronic Signature*
34. Date*
    Date
Leave This Blank:


35. 1. Receive an email copy of this form.
36. Email address

    This field is not part of the form submission.

37. Submit

* indicates a required field