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Volunteer Form
FIRST NIGHT BUFFALO 2004 Wednesday, December 31, 2003 from 5:00 p.m. to approx. 9:30 p.m.
Name:_______________________________________________
Address:_____________________________________________ City:_______________________State:_______Zip:__________ Phone: Day__________________ Evening_________________ NOTE: Volunteers must be at least age 12 and up Please check one of the following to help assist with placement
What role would you like as a volunteer? Please check one of the following...
Please check the time you desire (we ask that all volunteers work one of the shifts scheduled below)
PLEASE NOTE:
REQUESTING A SPECIFIC VOLUNTEER ROLE, SITE OR SHIFT DOES NOT NECESSARILY GUARANTEE THAT YOU WILL BE PLACED
ACCORDINGLY; HOWEVER WE WILL MAKE EVERY EFFORT TO ACCOMMODATE YOUR REQUEST.
PLEASE NOTE: SPACES ARE FILLED ON A FIRST COME FIRST SERVE BASIS. CONFIRMATION OF YOUR ASSIGNMENT WILL BE MAILED TO YOU BY THE BEGINNING OF DECEMBER.
If you would like to volunteer with a friend or family member, or prefer to volunteer at a specific site or with a
certain site manager, please write this information in the space provided below. Also, if you have any limitations (ex. No lifting, no standing
for long periods) please inform us.________________________________________________________________________________
____________________________________________________________________________________________________
___________________________________________________________________________________
Please Return this form as soon as possible to:
Independent Health Foundation, 511 Farber Lakes Drive, Buffalo, NY 14221 (716) 635 - 4959 Fax (716) 635 - 3984 www.firstnightbuffalo.com FOR INTERNAL USE ONLY
Assignment:__________________________________________ Time:__________________________
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