Untitled Document

WalkItUp! Cabell County
Volunteer Information Form

Name:

Title/Position:

Organization:

Address:

City:

State:

Zip Code:

Phone Number:

Email Address:

Please answer the following questions to help identify the needs of the WalkItUp! members.

1. Are you currently involved in an organization, group or know any individuals that would be interested in participating in WalkItUp!? If yes please list their contact information.
Yes No Others Interested in Participating?
2. I would be interested in serving on one or more of the following committees: Physical Activity Opportunities: Guide, walking clubs, assessments, etc Community Events: Walking campaigns, marathons Fundraising: Planning and funding for marketing ideas
3. The best day/time of the week for me to attend a WalkItUp! meeting is:
Monday Tuesday Wednesday Thursday Friday	Noon - 1PM (Lunch Meeting) 4PM - 5PM 5PM - 6PM 6PM - 7PM
5. Please select which areas you live or work in that you would like to be involved in WalkItUp! activities:
Huntington Barboursville Milton Culloden Lesage Ona Salt Rock Other (Please Specify):