Volunteer Form

Thank you for your interest in volunteering for IML, please fill in the required fields below. If you need to change or cancel any shift please DO NOT resubmit an application online, please contact Dkatzenberg@imrl.com and indicate what needs to be changed/canceled. Thanks again and remember to have fun volunteering!!!!!

First Name (required)

Last Name (required)

Street Address (required)

City (required>

State/Province

Zip

Country

Home Phone

Mobile Phone

Best Time to Call

E-Mail Address (required)

What name should appear on your badge? (required)

If you work a 12-step program would you like to be identified with an orange recovery ID badge? (Check for 'Yes')

Person to Contact in case of an emergency (required)

Relationship to Emergency Contact (required)

Emergency Contact number (required)

Are you Local to the Chicago Area?

Are you available for the May 17, 12:00 pm to 3:30 pm package stuffing? (Check for 'Yes')

What Physicial Limitations do you have, if any? (Check for 'Yes')

Other Comments?

Select your first volunteer shift
please choose the time of the shift (required)

Select your second volunteer shift
please choose the time of the shift (required)

Select your third volunteer shift
please choose the time of the shift (required)

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