Wednesday, February 22, 2012
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Week of Action Volunteer Registration
*
Name of Volunteer:
*
Email address:
*
Mailing address:
*
City, State, Zip:
*
Phone number:
Cell number:
Team/Company Name (if applicable):
Additional participant name (for teams with more than 5 participants, only the names of Team Leaders or key contacts are required):
Additional participant email:
Additional participant name:
Additional participant email:
Additional participant name:
Additional participant email:
Project Details, if you have a project in mind (title, description, goals, benefiting organization, etc.):
I am most interested in volunteering in the area of:
Health
Education
Income
No preference
T-shirt orders (The LIVE UNITED t-shirts are available at the UWCA office for $5 each for WOA volunteers):
Small
Medium
Large
XL
XXL
3XL
Enter the code shown above:
(Items marked
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are required)