volunteer registration form

contact information please check S the preferred method(s) of contact

First and Last Names Date of Birth Age

Employer Email Address

Home Address

Street City State Zip

Contact Telephones

Home Cell Work

volunteer interests please check all that apply

Work With Kids at the Units

Technology -Teaching software & various learning projects like web or graphic design… in the Tech Room

Education - Group and individual tutoring and high yield learning activities in the Learning Room)

Arts - Leading kids in art projects using a variety of media in the Art Room)

Physical Education and Recreation - Leading kids in activities involving physical exertion – dodge ball....

Social Recreation - Leading kids in a variety of games –pool, air hockey… in the Games Room

Work With Kids in the Classroom

SMART Moves - Drug and alcohol resistance training

Positive Sprouts – Gardening Program

Be Great Graduate - Mentoring Program

Work With Kids in the Community

Athletics: Football Basketball Volleyball (This program requires weekends and evenings) contact Shawn Nicholson at 479-273-7187 or for more information)

Assist with General Maintenance or Special Events

Please specify your skills or your desired project

availability and location

Summer Program
(June -August) / After School Program (Aug - May)
mon / tue / wed / thu / fri / mon / tue / wed / thu / fri
7 - 8 AM / 3 – 4 PM
8 - 9 AM / 4 – 5 PM
9 - 10 AM / 5 – 6 PM
11 - 12 AM
12 - 1 PM / Facility/Community Preference
1 - 2 PM / McKinney Bentonville Unit, 2801 N. Walker
HLM Bentonville Unit, 1207 NW Leopard Lane
Rogers Unit, 409 S. 8th Street
Bella Vista Unit, 2260 Forest Hills Blvd.
2 - 3 PM
3 - 4 PM
4 - 5 PM