Group Volunteer Request Form

Date:(mm/dd/yyyy)

Group Name: (school, business, church. etc.)

Contact Person:

Address 1:(street)

Address 2:(city, state, zip)

Contact Phone Number:

Cell Phone Number:

Areas of Interest:

(homeless shelter, daycare, administrative, public relations, etc.
Please note that daycare requires clearances and social security number)

Group's Objective:

(Scout Badge, Internship, Community Service, Just want to help)

Adult Supervisor: (if group is under the age of 16)

Availability:(Start-Finish: Days & Hours)