Recycling Volunteer Program: New Volunteer Pre-Registration

First Name
Last Name
Preferred Nickname:

About you...

E-mail Address:

Street Address:
City: State:
ZIP Code:

Home Phone Number:
Work Phone Number:
Cell Phone Number:
Where is it best to reach you: Home Work Cell All phone numbers

What is your birthday: (Month/Day only)

Check if applicable:
This is for Student Service Learning hours.
This is for court-ordered service.

Why would you like to volunteer with us? What do you hope to gain from the experience?

How did you hear about us?

Emergency Information

Name of Emergency Contact:
Emergency Contact Phone Number:
Relation to Emergency Contact:

Personal References

Please list two people who would be willing to serve as personal references.

Please list two references, and their daytime phone numbers

What are your interests?

Please check all that apply. For more information, visit our Volunteer Opportunities page.

Speakers Bureau-Recycling
Speakers Bureau-Composting
Speakers Bureau-Worm Composting
Composting Workshops
Fairs and Festivals
Household hazardous waste collections
Block Captain
Office assistance
Other

Mailing Preference

Use e-mail for as much as possible
Send me information in the mail.

Anything else you would like us to know?

Do you belong to any groups that might wish to volunteer with us? Are you only available on Saturdays? Or, are you a Sunday-only person? Knowing your preferences lets us contact you for activities in which you are more likely to be able to participate.

I certify that the statements made in this volunteer pre-registration are true and correct. I hereby authorize the Division of Solid Waste Services to use any photographs taken of me performing my volunteer services in print and electronic media.

Check here to agree with this statement.