Name *

First Name

Last Name

Phone *

(###)

###

####

Is your org. a 501(c)(3), (4) or (6) non – profit organization or are being fiscally sponsored by a non -profit organization?

Yes

Other

Are you currently a member in good standing with the Leavenworth Chamber of Commerce? *

Yes

No

Will you be the volunteer manager that will be coordinating the volunteers for the selected weekends? *

Yes

No

What period THAT YOUR ARE CONFIDENT YOU CAN STAFF is your FIRST choice? *

ONLY CHOOSE ONE

C1 - Nov 28-30

C2 - Dec 1-7

C3 - Dec 8-14

C4 - Dec 15-21

C5 - Dec 22-24

C6 - Dec 6, 13, 21, 23

What period, that you are able to staff, is your SECOND choice? *

ONLY CHOOSE ONE

C1 - Nov 28-30

C2 - Dec 1-7

C3 - Dec 8-14

C4 - Dec 15-21

C5 - Dec 22-24

C6 - Dec 6, 13, 21, 23