City of Thornton Youth & Teen Volunteer Corps
Please complete this form and return to:
Jenny Dowdell
720-977-5934
Jenny.dowdell@cityofthornton.net
Please complete thoroughly:
Name: Date:
Address: City: Zip:
Email:
Home Phone: Birth Date:
School Attended:
Emergency Contact Name: Relationship:
Phone : Email:
Best number to reach emergency contact during our program hours
Do you have any medical condition/s that would limit your ability to perform your duties as a volunteer?
Do you have reliable transportation to and from the various volunteer projects?
Yes No
If you do not have transportation to our projects, do you have transportation to the Thornton
Community Center located at 2211 Eppinger Boulevard? Yes No
Do you have your own mask to wear at every project? Yes No
Are you doing this program for documented community service hours? Yes No
*You will need to provide documentation to be signed by staff at each volunteer project you attend!
References:
Name: Phone: Relationship:
Name: Phone: Relationship:
Name: Phone: Relationship:
Applicant Signature:
Please turn over and complete the back