Volunteer

Summer 2012 Volunteer Registration Form

PROGRAM YOU ARE INTERESTED IN VOLUNTEERING AT:
- Oakland Freedom School (ages 5-13): TBA, 2012
- Camp Akili (ages 14-17): TBA, 2012
Name
FirstLast
Middle Name
Gender
Age
Date of Birth
Address
Street AddressAddress Line 2CityState / Province / RegionZip / Postal CodeCountry
Mailing Address (if different)
Street AddressAddress Line 2CityState / Province / RegionZip / Postal CodeCountry
Home Phone
Daytime Phone
Cell Phone
Email
How Did You Hear About Us?
I give permission for media release with the understanding that any photos, articles, student work, video footage, etc of me may be used for promotional materials. I understand the goals of Leadership Excellence and gladly support the LE facilitators, in achieving these goals. Forward! By clicking SUBMIT below you are digitally signing this form ).*
- I Agree

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Nick James