LEGACY Volunteer Application Form

Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

E-mail*

Phone Number*

Area CodePhone Number

Volunteer Location*

Glencoe (372 Hazel Ave, Glencoe Il 60022)Chicago (900 N Michigan, Chicago IL 60016)Old Orchard (4905 Old Orchard Shopping Center, Suite N9)

Volunteer Availability (Check all that apply)*

Volunteer Availability (Check all that apply)*

Volunteer Availability (Check all that apply)*

Areas of Interest (Check all that apply)*

Skill sets / Area of Expertise*

Previous Volunteer Experience*