Data Center Development Standards Committee Volunteer Application

Data Center Development Standards Committee Volunteer Application
Name

First NameLast Name
E-mail
example@example.com
Phone Number
Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Describe the type of volunteer work you would like to do.
What skills, if any, do you have that would be of benefit?
Please check the days you would be available to volunteer.

Other
Monday

Hour Minutes

AM/PM Option

Until

Hour Minutes

AM/PM Option
Tuesday

Hour Minutes

AM/PM Option

Until

Hour Minutes

AM/PM Option
Wednesday

Hour Minutes

AM/PM Option

Until

Hour Minutes

AM/PM Option
Thursday

Hour Minutes

AM/PM Option

Until

Hour Minutes

AM/PM Option
Friday

Hour Minutes

AM/PM Option

Until

Hour Minutes

AM/PM Option
Emergency Contact

First NameLast Name
Phone Number
Format: (000) 000-0000.
I understand that as a volunteer, I represent the City of Lamar. I also understand that although I will not be covered by Workman’s Compensation, I am provided a measure of personal accident insurance by the City of Lamar. I further understand that as a volunteer, I am ultimately responsible to the City of Lamar but will coordinate my volunteer activities through the City Council Board member, Mark Headlee, who is assigned to supervise my volunteer activities.
Volunteer Signature
Document

Cancelof
Volunteer Activities Release Indemnification form
Should be Empty: