VOLUNTEER INFORMATION:

Application Date:  Your Name (* Required) E-Mail Address: (* Required) Address: (* Required) City: (* Required) State: Select State AL AK AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY OTHER - List in additional comments area (* Required) Zip: (* Required) Telephone: (* Required) Fax: Are you a WDS member? Yes No..- PLEASE NOTE: WDS Membership Required to Host an Event (For information on becoming a member click HERE)

OUTREACH EVENT INFORMATION:

Location of Outreach Event: City of Outreach Event: Date of Outreach Event: (* Event must take place by the end of the second week in May) Estimated number of participants: Summary of Outreach Event:

AVAILABLE TOOLS AND RESOURCES--YOU CHOOSE!:

Just check the boxes for the items you would like WDS to include in your customized Sun-Safety Education Kit! Customized Options: Coloring Contest Sun-Safety Quiz (download PDF version now) UV color-changing bracelets Sunscreen Samples (will include permission slips) Check here if you would like WDS to include materials in Spanish Additional Options: If you would like to sign-up your school or organization for a SunWise kit, please visit http://www.epa.gov/sunwise/becoming_partner.html (opens in a new window) (Please note WDS as the referring organization so we can keep track) SunWise also offers age specific PowerPoint presentations that you may find appropriate for your outreach event. You can download one or all at http://www.epa.gov/sunwise/educator_resources.html (opens in a new window)

ADDITIONAL COMMENTS OR QUESTIONS:

PLEASE NOTE: You will receive an eMail conformation on your WDS Volunteer Sign Up Request.