VOLUNTEER FORM

Camden County,
North Carolina

Date: ___________________

Thank you for your interest. We are delighted to know you are willing to serve our community. How would you like to serve?

_______	Planning Board
_______	Board of Adjustment
_______	Social Services Board
_______	Senior Center Advisory Board
_______	Pasquotank – Camden Library Board
_______	Other: (Name any other board, committee, or area of interest) _________________________________________________

When are you available?

Check all that apply

_______ Daytime

_______ Evenings

_______ Weekends

Name	____________________________________________________
Street	____________________________________________________
City, State, Zip	____________________________________________________
Home Phone	____________________________________________________
Work Phone	____________________________________________________
E-Mail	____________________________________________________

Volunteer Forms are kept on file for one year