Group Leader Interest Form
Organization Name
Group Type
Please select...
College/Univ
Community
Corporation
Government
K-12
Non-profit
Other
Religious
Grade Level
Please select...
Preschool - Kindergarten
1st - 4th
5th - 8th
9th - 12th
Phone
Website (www.website.com, no http://)
The web address will properly link your request to our internal database without producing duplicates. If you do not have a web address, use your group name as one word. Example: www.knightsofcolumbus.com
Social Media Link
Please provide your social media link so that we can post photos from your visit.
Organization Address
City
State
Please select...
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Postal Code
Group Leader Contact Information
First Name
Last Name
Email
Cell Phone
If you do not have a cell phone number, enter in another phone number unique to you.
Volunteering Request Details
Total # of Volunteers Anticipated
Please specify a date range for volunteering availability.
** Please note that we are currently scheduling for July 1st and beyond. May and June are filled to capacity **
Date Request - 1st Choice
Date Request - 2nd Choice
Date Request - 3rd Choice
Location Preference
Please select...
North Grafton (05/02 thru 10/15)
Harvard (9/1 - 10/15 M,T,W,F 9-12 only, groups of up to 30 participants per day)
Notes/Special Requests
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