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2. First Name:*
3. Last Name:*
5. Phone Number:*
6. Email Address: *
8. Are you 18 years or older?*
   -- Select One --YesNo
9. Number of hours required:*
10. Date you need the hours done by:*
    Date you need the hours done by:
12. Please tell us the specific circumstances and reasons behind why you need to perform Community Service:*
14. Please complete and sign the liability waiver below. You will need to download it to your computer in order to digitally sign it.
    BAS Liability Waiver
16. Please upload the completed liability waiver.*
18. Please read the following policy document and sign your name below.
    BAS Rules and Procedures for Compulsory Community Service Volunteers
20. Once you have read the above required Community Service Policy, please agree to the terms laid out in it by typing your first and last name below. *
Leave This Blank:


24. 1. Receive an email copy of this form.
25. Email address

    This field is not part of the form submission.

26. Submit

* indicates a required field