Volunteer

Change the Culture of Violence
Volunteer Registration

* First Name:
Middle Name:
* Last Name:
Organization:
* Phone: ( ) -
Fax: ( ) -
Email:
* Address:
* City:
* Zip:
Availability:
Sunday to
Monday to
Tuesday to
Wednesday to
Thursday to
Friday to
Saturday to
* Comments/Suggestions

Instructions: Fill out the form above and click the "Submit" button to send your information online, or print the form, and fax it to:

Coalition to Change the Culture
Fax: 313-224-0818
Email: 3cv@co.wayne.mi.us