NEW LENOX COMMUNITY PARK DISTRICT

Mailing Address:     One West Manor Drive                        

                             New Lenox, IL 60451

                             Phone:  815.485.3584

                             Fax:  815.485.3589

Website:                 www.newlenoxparks.org

 

VOLUNTEER FORM

VOLUNTEER INFORMATION:

 

FIRST NAME: ___________________________LAST NAME: _______________________________

ADDRESS: _________________________________________________________________________

CITY: __________________________________STATE: _________ZIP CODE: _________________

PHONE: (        ) _________________________  DATE OF BIRTH: ____________________________

                                                                                                                         MM/DATE/YEAR

EMERGENCY CONTACT:

NAME: _____________________________________________________________________________

PHONE: (        ) _________________________ RELATIONSHIP: _____________________________

 

VOLUNTEER SIGNATURE:                                                                       DATE: _________________

 

AREAS OF INTEREST INCLUDE:

 

_____________________________________________________________________________________

 

_____________________________________________________________________________________

 

_____________________________________________________________________________________

All completed volunteer forms may be mailed or dropped off at the Lions Community Center, One West Manor Drive, New Lenox, Illinois or faxed to 815.485.3589.

 

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FOR OFFICE USE ONLY

SUPERVISOR INFORMATION:

 

LOCATION/DEPARTMENT: __________________________________________________________

 

SUPERVISOR’S SIGNATURE: ________________________________________________________

 

FIRST DATE OF SERVICE ___________________________________________________________