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2023 Summer Volunteer Form
Every new and returning volunteer must complete this form. If you have any questions or concerns, please call the office at 203-426-0666 or email
lofskiers@gmail.com
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* Indicates required question
Email
*
Your email
Volunteer Name
*
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
Nickname
Your answer
Mailing Address, please include Zip Code
*
Your answer
Phone Number (No Dashes)
*
Your answer
Occupation
*
Your answer
Current Employer, School/College and Address
*
Your answer
Are you:
Active Military
Retired Military
Veteran
Reserves or National Guard
Not involved in the Military
Clear selection
Do you have a Disability?
*
Yes
No
If you answered yes, please describe.
Your answer
Please describe any medical conditions , medications or allergies that we should be aware of.
*
Your answer
Emergency Contact Person
*
Your answer
Emergency Contact Number (No Dashes)
*
Your answer
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