Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Contact Information Applicant Name *FirstLastEmail *Phone *Address *Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeEmergency Contact Name *FirstLastPhone *EducationHow many years of High School are completed? *1 Year2 Years3 Years4 YearsHigh School Attended *How many year of College are completed? *0 Year1 Year2 Years3 Years4 YearsColleges Attended *General, Availability, & InterestsList any work or volunteer experience working with individuals with disabilities or disability related needs. Include place, length of time, age, and type of disability. *Why do you want to volunteer with LWSRA? Include if personal interest or volunteer hours are needed for school or similar program. *How did you hear about LWSRA? *Have you ever been convicted of a sex offense as defined by the Illinois Criminal Code or are you required to register as a sex offender under the Illinois Sex Offender Registration Act? *YesNoPursuant to 70 ILCS 1205/8-23(a), the Lincolnway Special Recreation Association requires disclosure of certain criminal offenses for individuals seeking to volunteer.Please describe your availability below. ( Days & Times) *Check your interest area below *TITANS Day ProgrammingClub Hawk AftercareSummer CampsYouth Programming (3-14)Teen Programming (14-22)Adult Programming (22 & Up)Mark any interest you have below *SoftballVolleyballGolfTrack & FieldSwimmingGymnasticsBowlingTennisWheelchair BasketballWheelchair SoftballDrama/MusicCookingArtDo you have other skills and talents? If so list below.Thank you for taking the time to fill out the LWSRA Volunteer Application. We will be reaching out soon.Submit
