Volunteer Application
Please fill this application out to be considered as a prospective volunteer with Cycling Without Age McHenry County
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Name *
Address  (Street, City, Zip) *
Cell Phone Number *
Email Address *
Date of Birth *
MM
/
DD
/
YYYY
Employment Status *
Why are you interested in becoming a volunteer in the Cycling Without Age McHenry County program?
 *
Are you physically able to pedal a bicycle for 30-60 minutes? *
If you answered No - Other Reason, please elaborate on any limitations
Please check any particular days/times that you could generally be available. Note - this is NOT a firm commitment. You can volunteer whenever and how little or often you want.
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
9 am - Noon
1 - 4 pm
Does your availability change during the summer months (e.g. teacher, student, seasonal work, etc.)?
We need volunteers to transport the trishaws. Do you have a: *
Yes
No
Trailer hitch on your vehicle and be willing to tow a light trailer?
Pickup truck with a 6-foot bed (with tailgate down), and be willing to transport a trishaw in your truck bed (we supply ramp)?
Do you have an area of the county you prefer?  Please check all that apply.
 *
Required
Do you consent to the use of your image, either through photographs or narrative description by Cycling Without Age McHenry County?
*
Do you consent to having a criminal background check performed? *
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