HOW WOULD YOU LIKE TO HELP?

NAME ___________________________________________________________________

Address___________________________________________________________________

City_____________________________State_________________Zip__________________

Phone Number (       )__________________________

Day & Time best for you to volunteer____________________________________________

     Check all that apply:

1. Administrative Help

    ______Bookkeeping/Accounting

    ______Clerical Help

    ______Computer Operations

2.  Facility Maintenance & Improvement

    ______Carpentry/Painting

    ______Electrical/Plumbing Repair

    ______Grounds Keeping

3.  Staff Assistance

    ______Medical/Dental Assistance (Please specify)

    ______Showing children How to Draw/ Paint/ Dance/ Play Music (Please specify)

______________________________________________________________________________

    ______Helping with Meals & Snacks

4.  Community Outreach

    ______Designing Promotional Materials (flyers, Inc.)

5.  Donations

     ______We would like to donate services

     ______We would like to donate products

     ______We would like more information on how we can get involved

Please list any other ways you'd like to help:

__________________________________________________________________________________

__________________________________________________________________________________

__________________________________________________________________________________

Please Print this form.  Then fill this form out and mail to:

Volunteer Application

Heartland Head Start

P.O. Box 1585

Bloomington, IL  61702-1585