* denote a required field

* Name:

* E-mail Address:

* Daytime Phone:

Do you or any member of your group require transportation accommodations (due to any disability or injury)? Yes No

If 'Yes', please describe (accommodations needed, number of participants needing accommodation, etc.)

If yes, are you under contract for transportation with the Center for Students with Disabilities?
Yes No

* I would like to volunteer. If 'Yes', please fill out the information below before submitting.
Yes No

* I am Signing up as a:

Student (Individual)
Student Organization
Residence Hall
Staff/Faculty
Community Member

If you selected Student Organization, New Student Seminar Group or Residence Hall, please fill out the following two fields. Otherwise, leave these empty.

Organization/Complex Name:

Number Participating:

* I will report to Cravath Lake Park at: 9:00am 12:30 pm either time

* I have a task preference (see choices below): Yes No

If you answered yes above, please indicate your first two preferences.While we will do our best to assign jobs based upon preferences, assignment is based upon job availability and timeframe of work.

My first choice is:
Departmental Assistance
Project Work (Indoor)
Cleaning (Indoor)
Trash Pickup (Outdoor)
Yard Work
Painting Water Clean-up (River and Lake)

My second choice is:
Departmental Assistance
Project Work (Indoor)
Cleaning (Indoor)
Trash Pickup (Outdoor)
Yard Work
Painting Water Clean-up (River and Lake)

Shirt size I prefer:
Small
Medium
Large
X-Large
XX-Large

Number of shirts needed for my group (only for Student Organizations and Residence Halls). Do not include your own shirt in this count.

Small

Medium

Large

X-Large

XX-Large

* I agree to hold harmless the UW Systems, UW Board of Regents, UW-Whitewater, City of Whitewater, and all those participating:
Yes No