Date:

Name:

Address: City: State: Zip Code:

Primary Phone Number: Alternate Phone Number:

E-mail:

How do you prefer to be contacted?

Phone
E-mail

When is the best time to contact you?

If you are younger then 18 years of age: Birth date: Student Grade Level:

VOLUNTEER POSITIONS

Please check all volunteer positions for which you would like to be considered.

List your top preferences: (1) (2)

If you have a suggestion for a project utilizing your interests/abilities not listed below, please contact the volunteer coordinator.

Education

Natural Resource Management

Wildlife Resource Center

Prairie Trail Safety Watch (Bike and Walk)

Glacial Park Ski Patrol (Nordic Ski)

Adopt-A-Trail

Administrative and Maintenance

AVAILABILITY

What days of the week are you available to volunteer?
Monday Tuesday Wednesday Thursday Friday Saturday Sunday

Most convenient time to volunteer:
Daytime Evening From to

Do you prefer:
a regular schedule (such as volunteering on day per month or afternoon per week)
to plan your own schedule of volunteer activities with the Volunteer Coordinator or MCCD staff member
to be contacted by the volunteer coordinator on an "as needed" basis

I prefer to volunteer at a specific MCCD site
- - - Site Name

Please tell us about your relevant interests, skills, hobbies, experience or education (for example: teaching, public speaking, outdoor recreation, computers, local history, sewing, crafts, ecology, gardening, birding, advocacy)

What do you do you hope to gain from your volunteer experience at the McHenry County Conservation District?

IN CASE OF AN EMERGENCY. please contact the following: (if under the age of 18, list parent/legal guardian first)

(1) Name: Relationship:

Phone: Alternate Phone Number:

(2) Name: Relationship:

Phone: Alternate Phone Number: