Name *

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Home Phone

(###)

###

####

Cell Phone

(###)

###

####

Preferred Method of Contact *

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Phone

Email

Text

Community Availability *

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High River

Okotoks

Black Diamond

Turner Valley

Blackie

Cayley

Nanton

Claresholm

Vulcan

Availability *

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Daytime

Evenings

Weekends

Weekdays

Spring

Summer

Fall

Winter

Age *

Under 18

18-25

26-49

50+

Program of Interest *

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FoodConnexx (Food Rescue, Bread Days and Occasional pick up runs)

Grocery Delivery

Essential Transportation

DadConnexx

Caring Visitor

Memory Cafe

Community Companion

Practical Kindness

SeniorConnexx

Committee/Board

Check all that apply.

Special Events and Fundraising Committee

Board Member

Grant Writer

Special Events

Check all that apply.

Ticket/Raffle Sales

Fundraisers

Awareness/Promotion

Office Assistance

Check all that apply.

Office/Clerical

Graphic Design/Social Media

Event Planning

Photography (On-SIte or at Events)