Yes! I Am Interested in Becoming a Volunteer Beachkeeper with the Adopt a Beach Program

Yes! I am interested in becoming a volunteer “beachkeeper” with the Adopt a Beach Program.

Name______

Address______

Phone______email______(Please print clearly)

1. I know of a group that would be interested in forming a team

Name of group:______

2. I am available for training on a weekend day.

No_____ Yes _____ If Yes, give best day and morning or afternoon: ______

3. I would prefer the training be held on a weeknight.

Yes______No______

4. I am usually not available the following nights: Mon Tues Wed Thurs

5. The earliest time of day I could attend on a weeknight is: (ex: 6 pm, etc.)______Beaches:

1. I would like to adopt the following beach (please choose from the list below. If you don’t see your beach listed, write it in.)

______

2. If that is not available, my second choice its: ______

3. I don't care; just assign me where you need me. (Please check) ______

Beverly: Salem: Marblehead: Manchester: Dane St. Beach Collins Cove Devereux Beach West Manchester Independence Beach Derby Wharf Beach Riverhead Beach Black & White Beaches Woodbury Forest River Park Grace Oliver Beach Long Beach Mingo Beach Dead Horse Beach Stramski Beach Tucks Point Beach Patch Beach Salem Willows Gas House Rice Beach Winter Island Nahant: Lynch Park Swampscott: Tudor Obear Park Phillips Beach Short

201 Washington Street, Suite 9 | Salem, MA 01970 | PH 978.741.7900 | FX 978.741.0458 salemsound.org Goat Hill Beach Danvers: Canoe West Beach Sandy Beach, Danvers River Sandy Point

201 Washington Street, Suite 9 | Salem, MA 01970 | PH 978.741.7900 | FX 978.741.0458 salemsound.org