If you would like to support GRADE A PLUS and our mission for a "healthy community and healthy youth" with a donation of time, talent or financial support.

GRADE A PLUS A United Way participating agency.
Adult Volunteer Application
P.0. Box 581, West Burlington, Iowa 52655 (319-752-6027)
Office hours 8:00 to 4:30 Monday thru Friday
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Please check one or more volunteer opportunities that you would be interested in doing.
*Due to liability insurance reasons, GRADE A PLUS is required to check all volunteers against the Sex Offender Registry.  This is why this information is required from our volunteers.

City:
State:
Zip Code
(mm/dd/yyyy)
Name:
Address:
E-Mail Address:
Home Phone:
Cell Phone:
Birth Date:
Do you have health or physical condition to be considered in arranging volunteer activities?
Emergency Contact:
Phone Number:
How did you hear about GRADE A PLUS?
Photographs taken of you may be used for media purpose.(newsletters- newspaper- GRADE A PLUS website)
I would like notices of Volunteer Events by:
How often would you be interested in volunteering?
-Teddy Bear Picnic, Red Ribbon Week, Rockin Safe Eve and Death by Chocolate
- Community Mobilization Tracing, Speaker's Bureau, various training's.
-Involved Volunteer Youth clearing house.
- budget, accounting, fundraising, grants and donations
-Marketing,Brochure, Marketing events and programs
- Community Liaisons, Participation with schools.
-surveys,Evaluation of events and program, community evaluations.
((319) 999-9999)
((319) 999-9999)
What days of the week and time of day you would be interested in volunteering?
How much time would you be interested in volunteering?
MaleFemale
YesNo
E-MailMailingsPhone
Activities/Events
Trainings
IVY
Finance
Media
Involvement/Recruitment
Evaluation Task Force