Hikeabilities Volunteer Form
You will be contacted when we receive your submitted volunteer interest form.
Full Name
*
First Name
Last Name
E-mail
*
example@example.com
Phone Number
*
Format: (000) 000-0000.
Are you over 18?
*
Yes
No
Which dates are you available?
*
Saturday, November 21st (Schuykill)
Saturday, December 5th (Schuylkill)
Saturday, December 12th (Schuylkill)
Saturday, December 19th (Schuylkill)
Tuesday, November 3rd (Churchville)
Tuesday, November 10th (Churchville)
Tuesday, November 17th (Churchville)
Why are you interested in volunteering for Hikeabilities?
Are you able to provide a copy of your PA Police Criminal Record Check (Act 34)?
*
Yes
No
Are you able to provide a copy of your PA Child Abuse History Clearance (Act 151)?
*
Yes
No
Which describes you best?
Please Select
Occupational therapy student
OTR
COTA
In another related field
Other
Submit Form
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