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2. *Must be 17 years old or older to register on this registry*
4. First Name*

   As it appears on State ID

5. Last Name*

   As it appears on State ID

7. Address*
9. City*
10. State*
11. Zip Code*
13. Email Address
14. Sex*
    -- Select One --FemaleMaleOther
15. Date of Birth*
    Date of Birth
17. Phone Number*
18. Phone Type*

    1. Home
    2. Work
    3. Cell
19. Race*
    -- Select One --WhiteBlackAsian or Pacific IslanderAmerican Indian or Alaska NativeUnknown/Other
23. I am interested in volunteering for (Please check all that apply):
25. Senior Citizens

    1. Clerical/Office
    2. Meals on Wheels
    3. Special Events
    4. Thrift Store
    5. Other
26. Community

    1. City Elections
    2. DDA Events
    3. Garden City Civic Theatre
    4. Fire Department Events
    5. Food Pantry
    6. Parks & Rec Events
    7. Santaland Parade
    8. Radcliff Garden
    9. Other
27. Youth/Family

    1. Figure Skating
    2. Youth Hockey
    3. Youth Tutoring
28. Community Organization

    1. GC Community Coalition
    2. Goodfellows
    3. Kiwanis Club
    4. Lions Club
    5. Rotary Club
30. Other
    Please let us know what volunteer opportunities interest you that are not on this list
34. I agree that the City of Garden City may conduct a conviction-only criminal check on me. I hereby consent to this search being conducted and to the disclosure of the results of the search to the Recreation Supervisor. I understand and acknowledge that criminal convictions may result in disqualification from the Volunteer Registry. I also authorize the Recreation Supervisor to release my contact information to organizations matching my interests.
36. Signature*
    By electronically signing this form you agree to the above statement.
37. Today's Date*
    Today's Date
Leave This Blank:


39. 1. Receive an email copy of this form.
40. Email address

    This field is not part of the form submission.

41. Submit

* indicates a required field