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2. Volunteers must be at least 16 years old. All volunteers will be interviewed for explanation of required responsibilities and questions and answers, and must pass a City of Moline background check prior to beginning your volunteer service.
4. First Name*
5. Last Name*
7. Address*
9. City*
10. State*
11. Zip Code*
13. Phone Number*
14. Email Address
16. Emergency Contact Name*
17. Emergency Contact Phone*
19. The Friends Rooms are open 6 days per week, Monday through Saturday. Do you have any day(s) of the week you cannot work?
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21. 1. Receive an email copy of this form.
22. Email address

    This field is not part of the form submission.

23. Submit

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