Agency / Organization Information Volunteer Coordinator/Agency Contact Name Agency / Organization Volunteer Coordinator/Agency Contact Email Volunteer Coordinator/Agency Contact Phone Number Opportunity Address/Location(s) Street Address City State FloridaAlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces (Canada, Europe, Africa, or Middle East)Armed Forces AmericasArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederated States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyomingAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNova ScotiaNorthwest TerritoriesNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon ZIP Code Project Information Is this opportunity a special event? Yes No Number of hours to complete project Approximate number of volunteers needed Description of opportunity Include a short description as you would like it to appear on the website so that we can present it to a group. Please keep your description to 100 words or less. Does this opportunity have an end date, or will this be ongoing? Please provide end date if applicable. Population Served (e.g., Seniors, Children, At-risk, Veterans, etc.) Will this be an indoor or outdoor enviroment? Indoor Outdoor What will you be providing for volunteers? (e.g., training, supplies, tools, water, snacks, lunch, etc.) What will volunteers need to bring for themselves? Will you be breaking up the opportunity into shifts? If so, how many? Please include time frames for each shifts. Age Requirement: What is the minimum age to volunteer at your agency for this project? What are the physical demands of this volunteer opportunity? (e.g., heavy lifting, fast pace, outdoor activity, etc.) How can volunteers register for this opportunity? Are there any other requirements we should know about that volunteers should be aware of? (e.g., specific attire volunteers need to wear, any safety protocols required, items they may need to bring, etc.) Requirements Does your agency have liability insurance to cover this project? Yes No Will an agency representative be available on the day of the event to coordinate & provide an overview? Yes No Is a plan in place to take photographs before and after the project? Yes No Signature Sign above Full Name of Signer Title of Signer CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. Submit
