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VOLUNTEER FORM

First Name
Last Name
Address Line 1
Address Line 2
City
State
Zip Code
Phone
Email
Occupation / Employer
I am a:
Parent Grandparent Family Member
Student Self-Advocate Professional
Other    
I would like to volunteer at a Special Event:
Annual Theatre Party (Saturday, February 17, 2007)
DSAGC Golf Tournament (Monday, June 25, 2007)
Sixth Annual Buddy Walk (Saturday, September 15, 2007)
Annual Summer Picnic - Coney Island (Sunday, August 5, 2007)
I am interested in serving on a special event committee:
Please tell us a little about yourself and why you would like to volunteer for the DSAGC:
   

DSAGC, 644 Linn Street Suite 1128
Cincinnati OH 45203-1734
Phone: 513.761.5400  Fax: 513.761.5401
Toll Free: 1-888-796-5504

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