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/MusicCookingArt below convicted List Do 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
