* 1. What is your first and last name?

* 2. What language do you speak? (Mark all that apply)

* 3. Have you gone through OHSU Volunteer Orientation and Training?

* 4. What is you cell phone number?

* 5. What is your email address?

* 6. Please mark the events you would like to volunteer at and select your volunteer shift in the next sections. Go to the next section.

* 7. Event: Day in Damascus

Date: Saturday, July 27, 2013

Time: 9:00 AM to 5PM

What you will do: Need volunteers to teach community members about the brain & spinal cord, injury prevention, and fit free bike helmets to kids’ heads.

100 Free helmets for kids & teens provided by OHSU ThinkFirst Oregon

Location: Damascus City Park, 20100 SE HWY 212, Damascus, OR 97089 (behind the Fire Dept. across from Safeway).

MARK ALL POSSIBLE SHIFTS BELOW:

* 8. Event: Health Fair—Free Bike Helmet Event Salud Medical Center.

Date: Saturday, August 10, 2013

Time: 9:00 AM to 3:00 PM

What you will do: Need volunteers to teach community members about the brain & spinal cord, injury prevention, and fit free bike helmets to kids’ heads.

100 Free helmets for kids & teens provided by OHSU ThinkFirst Oregon.

Location: Salud Medical Center, 1175 Mt. Hood Avenue, Woodburn, Oregon 97071

MARK ALL POSSIBLE SHIFT TIMES BELOW:

* 9. Event: Clackamas County Fair Kids Day

Date: Tuesday, August 13, 2013

Time: 9 AM to 6 PM

What you will do: Need volunteers to teach community members about the brain & spinal cord, injury prevention, and fit bike helmets to kids’ heads, assist with Safety Streets (a learning activity for kids and their family members ).

$5.00 bike helmets provided for the general public by OHSU ThinkFirst Oregon.

Location: 694 NE 4th Avenue Canby, Oregon 97013


MARK ALL POSSIBLE SHIFT TIMES BELOW:

* 10. Event: Clackamas County Fair Senior Day

Date: Wednesday, August 14, 2013

Time: 9:30 AM to 6 PM

What you will do: Need volunteers to teach community members about the brain & spinal cord, injury prevention, fall prevention, and assist with Safety Streets (a learning activity for kids and their family members).

$5.00 bike helmets provided for the general public by OHSU ThinkFirst Oregon.

Location: 694 NE 4th Avenue Canby, Oregon 97013

MARK ALL POSSIBLE SHIFT BELOW:

* 11. Event: OHSU Student Orientation Event


Date: Thursday, August 15, 2013

Time: 4:00 PM to 7:30 PM

What you will do: Need volunteers to new students about the brain & spinal cord, injury prevention, and run alcohol awareness activities.

$5.00 bike helmets provided for purchase OHSU ThinkFirst Oregon

Location: OHSU Student Center Gymnasium

* 12. Event: Clackamas County Safety Streets

Date: Saturday, August 17, 2013

Time: 10 AM to 6 PM

What you will do: Need volunteers to teach community members about the brain & spinal cord, injury prevention, pedestrian safety, and assist with Safety Streets (a learning activity for kids and their family members).

Location: 694 NE 4th Avenue Canby, Oregon 97013

MARK ALL POSSIBLE SHIFT TIMES BELOW:

* 13. Clackamas Town Center Road & Safety Fair

Date: Saturday, August 24, 2013

Time: 9:00 AM to 4:00 PM

What you will do: Need volunteers to teach community members about the brain & spinal cord, injury prevention, run safety activities, teach pedestrian safety, transportation safety, and fit free bike helmets to kids’ heads.

250 Free helmets for kids & teens provided by Clackamas County Safe Communities

Location: 12000 SW 82nd Avenue, Happy Valley, Oregon 97086 (Clackamas Town Center Mall)

MARK ALL POSSIBLE SHIFT TIMES BELOW:

* 14. Event: Metropolitan Family Service Free Helmet Event

Date: Sunday, August 25, 2013

Time: 1:00 PM to 6:00 PM

What you will do: Need volunteers to teach community members about the brain & spinal cord, injury prevention, run safety activities, run alcohol & the brain activities, and fit free bike helmets to kids’ heads
.
130 Free helmets for kids & teens provided by Clackamas County Safe Communities

Location: 6031 SE King Road Milwaukee, Oregon 97222

* 15.
Correct Date
Event: Metropolitan Family Service Free Helmet Event

Date: Sunday, August 18, 2013

Time: 1:00 PM to 6:00 PM

What you will do: Need volunteers to teach community members about the brain & spinal cord, injury prevention, run safety activities, run alcohol & the brain activities, and fit free bike helmets to kids’ heads
.
130 Free helmets for kids & teens provided by Clackamas County Safe Communities

Location: 6031 SE King Road Milwaukee, Oregon 97222

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Other (please specify)

Thank you for signing up to help us at our upcoming community events. Please email Kayt Zundel at zundel@ohsu.edu, once you have signed up for events. If you have any questions you can email or call Kayt Zundel, Program Director, OHSU ThinkFirst Oregon. Cell: 971-344-1154 office: 503-494-5353
I will email or call you with specific directions when we get closer to the events.
Thank you again!

T