Name:
Email:
Phone:
Address (Include City and Zip Code):
Are you participating as a member of a service group? No Yes
If yes, name of group or organization:
What time would you like to volunteer? 2-8 P.M. 4-8 P.M.
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Minor Adult
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5.
6.
7.
8.
9.
10.
For more information, contact Heather Grigsby at (209) 577-5445 or hgrigsby@modestogov.com.
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