Name: *

First Name

Last Name

Phone Number: *

(###)

###

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Emergency Contact Name: *

First Name

Last Name

Emergency Contact Phone Number: *

(###)

###

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I am interested in the following duties: *

Check all that apply.

Set-up - Assist vendors with unloading, post signage in building, etc.

Vendor and Volunteer Registration - Check in vendors and volunteers, direct them to their booths or the volunteer coordinator, etc.

Participant Registration - Greet event attendees, give them event information packets, etc.

Health Fair Ambassador - Monitor event, assist vendors and participants as needed, etc.

Break-down - Assist vendors with loading out, remove signage in building. etc.

I am interested in the following shift times: *

Check all that apply.

11AM-1PM

12:30PM-2:30PM

2:00PM-4:00PM

4:00PM-6:30PM

Any shift time

If you are a student, please check the box below and have your parent or guardian finalize this form. These volunteer hours can be used toward your required service hours for school:

Yes, I am a student.

Parent/Guardian Name:

First Name

Last Name