Volunteer Sign-Up
Name: ________________________________________ Age: ________
(Please print)
Phone (Home): ______________________________AM / PM
(Cell): ______________________________AM / PM
Email: ______________________________
Please mark boxes to indicate interest/skill in specific areas.
Construction:
q Plumbing: □ Basic □ Intermediate □ Advanced
q Electrical: □ Basic □ Intermediate □ Advanced
q Carpentry: □ Basic □ Intermediate □ Advanced
q Help with “pre-staging” team
General Skills/Interests:
q Basic Computer
q Home safety check
q Shopping
q Light House Cleaning
q Running Errands
q Transportation
q Home Winterization
q Grant Writing
q Painting (Outside)
q Painting (Inside)
q Light Hauling
q Clean up
q Car wash
q Window wash
q Yard Work
Visitation (Please indicate)
□ Nursing Homes
□ Home Bound
□ Hospital
Other: _______________
_______________
Please return completed form to: Deb Shaw
12 Rigg Dr.
Lincoln, IL 62656