Forms • Roseville • CivicEngage

Name*

Address*

Apartment #

City*

State*

Zip*

Home Phone*

Cell Phone

Email Address

Are you over 18 years old?*

Yes

No

Male or Female?*

Male

Female

When are you available to volunteer?

Monday

	Morning
	Afternoon

Evening

Tuesday

	Morning
	Afternoon

Evening

Wednesday

	Morning
	Afternoon

Evening

Thursday

	Morning
	Afternoon

Evening

Friday

	Morning
	Afternoon

Evening

Saturday

	Morning
	Afternoon

Evening

Sunday

	Morning
	Afternoon

Evening

Comments

Which areas are you interested in volunteering for?

	Nature Center
	Parks
	Recreation

	Cedarholm Golf Course
	Skating Center
	All

List your past/present volunteer experiences:

Why are you interested in volunteering with us?

List any special needs:

How did you learn about our volunteer program?

	City Website
	City Newsletter
	City Staff
	Volunteer Match

	Cable TV
	Refered by Other Volunteer
	Flyer
	Other

* indicates required fields.

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