Harambee Community Action Day: Please Return As Soon As Possible
Harambee Community Action Day: Please Return As Soon As Possible
Harambee Community Action Day: Please Return As Soon As Possible
Address: ____________________________________________________________________
Home Phone: (_) __________ Cell Phone: (_)__ ________ Office Phone: (_) ____________
__________________________________________________________________________
*Print Name of Volunteer
__________________________________________________________________________
*Signature of Volunteer
___________________________________________________________________________
*Print Name of Parent/Guardian of Youth Volunteer
__________________________________________________________________________
*Signature of Parent/Guardian of Youth Volunteer
Please select a volunteer area below. If selection is not made, you will be automatically
assigned to an area of need by the Volunteer Coordinator.
Volunteer Self Assignment: Volunteer Committee Assignment:
_____ Food Committee _____ Food Committee
_____ Volunteer Committee _____ Volunteer Committee
_____ Youth Committee _____ Youth Committee
_____ Resource Information Committee _____ Resource Information Committee
_____ Environmental Committee _____ Environmental Committee
_____ Day of Event/Traffic Flow Committee _____ Day of Event/Traffic Flow Committee
_____ Set-Up/Clean-Up Committee _____ Set-Up/Clean-Up Committee
RETURN FORM TO:
MS. HENRIETTA ALLEN, DIRECTOR
Interfaith Older Adult Programs, Inc.
Clinton Rose Senior Center
3045 North Dr. Martin Luther King, Jr. Drive
Phone: 414-534-1898
Fax: 414-263-1460
HCAD VRF 2010 Edition: 050310 Revised 052010