Please fill out the form completely and accurately.
Name:
Address:
City:
State:
Zip:
Phone: Day (Home/Work):
Evening:
E-mail:
Male:
Female:
Age Range:
Select an Age Range
Under 18
18 to 30
31 to 45
45 to 59
60+
Emergency Contact:
Name:
Phone:
Do you have any medical/physical conditions that might limit volunteer activities? If so, please elaborate.
Have you ever been indicted or convicted of a misdemeanor or felony? If so, please elaborate.
Any special skills, abilities or comments you would like to share?
Areas of Interest: Germantown Volunteer Corps
Check all areas of interest.
Community safety
Environmental projects
Clerical assistance
Help with children's activities
GVC Leadership Team
Use my technical skills
Work with seniors
Social/health issues
Community/special events
Other
Areas of Interest: Germantown Parks Ambassadors
Site Volunteer
Resource Mgmt.
Interpretive
Special Projects/Events
Administrative
