VOLUNTEER FOR MOTOR CITY MAKEOVER

ORGANIZATION VOLUNTEER FORM

Organization Information
 Organization Type :
 Organization Name:

Contact Information
 First Name:

MI:
 Last Name:
 Title:

Address & telephone Information
 Street No Street Direction:

 
 Street Name: (P.O.  Box Here)

 Suite #:        
 City:

State: Zip:

 Telephone Numbers:
 Daytime: - -

 
 Evening: - -    
 Fax: - -
 Email:

Community Information
 Police District
 Do you have a designated clean-up site?

 If No, Select the 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:

 Number of Volunteers: (Numeric value ONLY!!)
May 3 May 10 May 17

Specify the time to pick up supplies:

 Age (Minor/Senior Citizen/No):

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

Volunteer Interests
 Previously Volunteered:
 Other Volunteer Interests: Angels Night

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