Please complete this application if you are interested in completing community service hours.

Once you complete this form, click the submit button at the bottom. In 1-2 business days, you will receive an email with 'next steps' in the application process. If you do not see an email from us, please check your junk folder.

Completing this application does not obligate you to volunteer with PRC, nor does it guarantee a placement at PRC. Information contained on the application is treated confidentially.

Contact Information

First name:

Last name:

Street 1:

Street 2:

City:

State:

* Zip: *

Phone phone:

OK to call me here

Email address:

Community Service

Please tell us the name and city of the school or faith community, PRC Junior Board chapter, or court that you are completing the community service hours for.

Group/Organization:

City:

Community Service Details

Please tell us the type of community service, required hours and time frame for completing the hours.

Hours Due Date:

Required # of hours:

* Community Service for:

Please share what assignment or offense led to hours being required.

Availability

Community Service Hours are completed at our Wheaton and Westmont location Food Pantries by packing groceries, stocking shelves, and placing groceries into client’s vehicles.

Please indicate the days and times you are generally available to volunteer.

Demographic Information

This information is used to continuously learn more about our most valued human resource -- our volunteers.

Date of birth:

Gender:

Have you ever received our services?:

What is your current employment status:

How did you hear about us?:

Emergency Contact

We will use this information in emergency situations only.

Contact First Name:

Contact Last Name:

Phone phone:

Relationship:

Other Information you want to share