Please fill in the following form:

Volunteer Information:

Date:
Name:
Address:
City:	State:
Zip Code:
Voice Phone:
Fax:
Email:
Occupation:
Work Phone:
Please describe any special skills or interests:

Do you have any of the following skills or certifications?

American Sign Language

Teaching Certification

Physical or Occupational Therapy Certification

Chauffeur License

What types of volunteer work interest you?

Speaker's Bureau

Industrial Work (packaging, loading skids, etc.)

Handiwork (paint, repair, building maintenance, etc.)

Community Outreach

Administrative

Special Events (assist with open houses, parties etc.)

Please make checks payable to:

Over The Rainbow Association
2040 Brown Street
Evanston, Illinois 60201
Phone: 847.328.6633
Fax: 847.328.1404
info@otrassn.com