Home Community Project Sign-Up Form Community Project Sign-Up Form Participant Information: Full Name: Date of Birth: Address: City, State, Zip: Phone Number: Email Address: Project Selection: Which project would you like to participate in? Community Garden Initiative Youth Mentorship Program Neighborhood Outreach Assisting Elderly Residents of Jacksonville Other (please specify): Availability: Preferred Days: Monday Tuesday Wednesday Thursday Friday Saturday Sunday Preferred Time: Morning Afternoon Evening Skills and Experience: Please describe any relevant skills or experience you have for this project: Assistance for Elderly Residents: Do you have experience working with elderly populations? Yes No If yes, please provide details: Emergency Contact Information: Name: Relationship: Phone Number: Additional Information: Do you have any specific needs or accommodations? I consent to participate in the selected community project with Kaiwa Cares, Inc. I understand that my participation is voluntary and that I will be expected to adhere to the organization’s guidelines and policies. Signature: Date: Sign Up Participant Information: Full Name: Date of Birth: Address: City, State, Zip: Phone Number: Email Address: Project Selection: Which project would you like to participate in? Community Garden Initiative Youth Mentorship Program Neighborhood Outreach Assisting Elderly Residents of Jacksonville Other (please specify): Availability: Preferred Days: Monday Tuesday Wednesday Thursday Friday Saturday Sunday Preferred Time: Morning Afternoon Evening Skills and Experience: Please describe any relevant skills or experience you have for this project: Assistance for Elderly Residents: Do you have experience working with elderly populations? Yes No If yes, please provide details: Emergency Contact Information: Name: Relationship: Phone Number: Additional Information: Do you have any specific needs or accommodations? I consent to participate in the selected community project with Kaiwa Cares, Inc. I understand that my participation is voluntary and that I will be expected to adhere to the organization’s guidelines and policies. Signature: Date: Sign Up