Adaptive Swim Lesson Program – Volunteer Application Our program is seeking volunteers to help us succeed! Join us in making a difference in the life of a child. Fill out the application below. Adaptive Swim Lesson - Volunteer Application Volunteer Application for HAC Adaptive Swim Lesson Program Applicants InformationName(Required) First Last Email(Required) Phone(Required)Date of Birth(Required) MM slash DD slash YYYY Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Please check boxes that apply:(Required) I have volunteered with children with special needs before. I currently live with or know someone with special needs. I am currently enrolled in classes with a focus on adaptive learning. Select AllWhat is your comfortability level in the water?(Required) Comfortable in shallow water and submersion I can swim 25 yards I am a competent swimmer Are you available every Wednesday from September 6th to October 11th at 6 pm to 7 pm?(Required) Yes No Please select the days that will NOT work for you:(Required) Sept 6th Sept. 13th Sept. 20th Sept. 27th Oct. 4th Oct. 11th CAPTCHA ]
