What's your email address?

Your information


Required fields are marked with an asterisk (*). One of the fields below is a file upload/attachment, the file size must be less than 10MB.
First Name *
Last Name *
Mobile Phone *

For example, 123-456-7890
Volunteer Shirt Size *
Do you have any health issues or special needs we need to be aware of?
Birthdate *

A valid date as MM/DD/YYYY (for example: 11/30/2015)
Name of Business, Club, or School Affiliation *
Emergency Contact (name, phone#, and relation) *
Thank you for volunteering with Ashland In Motion. After you submit this information you will be directed to volunteer for shifts.