Back to Home Page


VIVA
Summer Program Application

For quicker processing, fill out the form completely. For additional information, please call
Katie Kang at 310-212-5009, or email youthprogs@volctr-sobay.org.
Name: (as you wish to have on your certificate)
Age:    (minimum 13 or will turn 13 by July 31)
School and grade level this fall:    
Parents' names:     
Home address:    
City:    State:    Zip Code:
Telephone number:       Parent's cell phone:
Alternate home address:     
City:    State:    Zip Code:
Telephone number:       Parent's cell phone:


I would like to attend Pre-Service Training on: (please choose one):

High School
Wed, June 25, 9:00am - noon

Middle School
Wed, June 25, 1:00-4:00pm

 I can attend either
My parent will attend Parent Orientation on the same day 30 minutes prior to end of training: Yes No

I'm interested in volunteering for the agency (ies) listed below and in the Program Description; please note that a minimum commitment of 20 hours for the summer is required:

(NOTE: To select multiple items, please use control key.)

Comments or Suggested Non-profit:

I have read through the requirements of the VIVA Summer Program  and will commit to completing them in order to receive my Certificate of Recognition. I understand that my registration will be official as soon as the registration fee is received, and I will be notified in June about the training.

Please enter name here:    E-mail Address:

 
  
The first 70 students will be accepted into the Program.


Please pay on-line, after you select the Submit Button above or send check to:

The Volunteer Center South Bay-Harbor-Long Beach  1230 Cravens Ave., Torrance, CA 90501

Attn: Katie Kang
The Volunteer Center South Bay-Harbor-Long Beach. 1230 Cravens Ave., Torrance, CA 90501
Phone: 310/212-5009 Fax: 310/212-7201 Email: youthprogs@volctr-sobay.org
Copyright © 2002-2008 All rights reserved.