VOLUNTEER FOR MOTOR CITY MAKEOVER

INDIVIDUAL VOLUNTEER FORM

Contact Information
 First Name: MI:
  Last Name:      
 Title:

Address & Telephone Information
 Street No Street Direction:  
 Street Name: (P.O.  Box Here)
 Apt:    
 City:

State:

 Zip:
 Telephone Numbers:
 Daytime: - -

Alternative:

 - -
 Fax: - -
 Email:
 

Community Information
 Police District
 Do you have a designated clean-up site?
 If No, Select Neighborhood City Hall (See Zip Code) You would like to be assigned.
 If Yes, list the Street boundaries of the site:
 North: South:
 East: West:

If clean-up site is park or playfield, Enter Name:

Select Volunteer Dates for current year :

May 3 May 10 May 17

Note: Report Blight to NCH by calling 313-224-3450. Report Abandoned Vehicles to your nearest police district

Specify the time to pick up supplies:

Age (Minor/Senior Citizen/No):

Number of additional Volunteers With Individual: (Numeric ONLY!!)

Volunteer Interests

 Previously Volunteered:

 Other Volunteer Interests: Angels Night

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