Organization Information

 Organization Type:
 Organization Name:

Contact Information

 First Name: MI:    
Last Name:
 Title:

Address & telephone Information

 Street No

Street Direction:

 Street Name: Suite #:
 City: State: Zip:
 Telephone Numbers:
 Daytime: - -

 
Evening: - -
 Fax: - -
 Email:

Community Information

Police Precinct

Neighborhood City Hall Assigned

Data Entered in Neighborhood City Hall

Patrol a Neighborhood

(October dates)

Designated Area to Patrol 

Watch a Vacant House/Structure

(October dates)

Turn on my Porch Lights

(October dates)

Address of vacant House/Structure

Data entry or other office Support

 Number of Volunteers:

Age (Minor/Senior Citizen/No)

Volunteer Interests

 Previously Volunteered
 Other Volunteer Interests Motor City Makeover

For Additional Information,
Please call the Volunteer Office Number at (313) 224-4415