Form Center

2. Title II Compliance

   In accordance with the requirements of Title II of the Americans with Disabilities Act (“ADA”) of 1990, the Fair Employment & Housing Act (“FEHA”), the Rehabilitation Act of 1973 (as amended), Government Code section 11135 and other applicable codes, the City of Modesto (“City”) will not discriminate against individuals on the basis of disability in the City’s services, programs, or activities. For more information, please visit the City of Modesto website.

6. Date Applied
   Date Applied
7. First and Last Name*
9. E-mail*
10. Address
12. Zip Code
13. City
14. State
15. Phone Number*
19. Check all applicable

    1. Evenings
    2. Weekdays
    3. Weekends

    1. Weekly
    2. Occasional
    3. Monthly
20. Age Requirements*

    If under the age of 18, all minors must be accompanied by an adult.

    1. I am over 18 years old
    2. I am younger then 18 years old
24. Is there anything specific you would like to volunteer for? If so, what?
    For example, Maddux Youth Center or Partners In Paint
26. Volunteer Interests

    Check all applicable

    1. Gardening
    2. Park/trail Clean-ups

    1. Special Events
    2. Tagging Removal

    1. Assisting at Community Centers
    2. Working with Senior Citizens

    1. Working with Children
    2. Program Leaders
Leave This Blank:


28. 1. Receive an email copy of this form.
29. Email address

    This field is not part of the form submission.

30. Submit

* indicates a required field