Name: Daytime Phone: Evening Phone: Address: City: State: Zip: Township: E-mail Address: Employer or School: City :
Are you interested in opportunities for you as an Individual or for a Group (size & type of group)?
Your Age Range?: Youth (<18), Adult (18-54), or Senior (55&over) Male or Female?
What type of volunteer activity are you interested in? (click one) One-Time Short Term On-Going No Preference
What is your time availability? (Weekdays, Weekends, Days, Evenings)
Do you speak another language(s) in addition to English? If so, please list:
Please let us know below if you have specific interests for volunteering or which opportunities you have seen on our web site which interest you:
2121 S. Goebbert Rd., Arlington Heights IL 60005 www.volunteerinfo.net volunteer@volunteerinfo.net