Volunteer with us | Cleanvalley

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Get involved with us by volunteering!

Volunteer Application

First Name

Last Name

Email

Code

Phone

Cell Phone

Check box if we can text you.

Street Address

Street Address Line 2

City

Region/State/Province

Postal / Zip code

Country

Volunteer Experience

Previous Volunteer Experience

Occupation (past occupation if retired)

Other information that will help us make a good match (such as education, general interests/hobbies)

Languages spoken

Availability and Volunteer Assignment Preferences

I am avalable:

Mornings (M-F)

Afternoons (M-F)

Evenings (M-F)

Weekends

I am avalable:

Once a week

More than once a week

One Time Only

Other

Details

I have a valid VA Driver's License

License Number:

License Plate Number:

Insurance Company and Policy Number

Have you ever been convicted for violation of any laws, traffic or otherwise? If yes, explain.

Do you have any physical condition that may limit your activities? If yes, explain

Emergency Contact Name and Number

Non-Family Member References

Reference Name and Phone Number

Reference Name and Phone Number

Reference Name and Phone Number

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Thanks for registering to our event. See you there!

ABOUT US

Clean Valley Council’s mission is to encourage environmental stewardship and lead the way towards a sustainable tomorrow by educating and inspiring those around us.

**While we are typically available Monday-Friday, our work often takes us away from the office. Please call or email us to set up an appointment.**

Serving locations in Virginia's Roanoke Valley

2014 Memorial Avenue SW

(Inside Heights Community Church)

Roanoke, VA 24015

CONTACT

T: (540) 345-5523

E: info@cleanvalley.org

© 2023 by Clean Valley Council.
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