Keystone Human Services

Volunteer Application and Request Form

Select the items that apply, and then let us know how to contact you.

* denotes required information

Area of Interest
I am interested in Volunteering. (Complete the Volunteers section below.)
I would like to know about being a Sponsor.
I would like information on being a Vendor.
Contact Information
Name*
Address*
City*
State*
ZIP*
E-mail*
Home Phone*
Work Phone
Volunteers

Age (if under 18)

Days and times you will be available (Please check ALL that apply.):

Pre-event
February – March
Friday, March 13, 2009
12:00pm - 4:00 pm
4:00pm - 8:00 pm
Saturday, March 14, 2009
7:00 am - 10:00 am
9:30 am - 1:00 pm
12:00 pm - 4:00 pm
Steward - Breed
9:30am - 2:00pm
Sunday, March 15, 2009
7:00 am - 10:00 am
9:30 am - 1:00 pm
12:00 pm - 4:00 pm
Steward - Obedience
7:30am - 11:00am
11:00am - 2:00pm
Tear Down
4:00 pm - 6:00 pm
Post-event
March – April

Job preference or limitations

Friends Who Would Like to Help

I have a friend that would like to help:

Comments

Contact

Susquehanna Service Dogs
Keystone Children and Family Services
3700 Vartan Way, Harrisburg PA 17110
Phone: 717-671-7813
E-mail: ssd @ keystonehumanservices.org
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Susquehanna Service Dogs
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Assistance Dogs International

Susquehanna Service Dogs is a fully accredited member of Assistance Dogs International.

This page last updated on:
February 5, 2009