Agency/Organization Name

Agency Contact Name

Agency Contact Email

Agency Contact Phone

Project Name (Please prepare 2 backup projects for each project submitted in case volunteers finish early. Where applicable, please also prepare an indoor project in the event of rain.)

Project Location/Address

Project Description

Please estimate the number of volunteers needed per project during the 4-hour period. If it is a range, such as 3-7 volunteers, include the low end and high end in the spaces below. If it is a solid number of volunteers needed, enter the same number in both fields.

Low range estimate

High range estimate

Volunteers are scheduled in 4-hour blocks, M-F, from 8am-12 pm or 12-4pm. Please check all shifts your project could be completed.

Questions	Yes	No
5/6 - Monday 8-12	Yes	No
5/6 - Monday 12-4	Yes	No
5/7 - Tuesday 8-12	Yes	No
5/7 - Tuesday 12-4	Yes	No
5/8 - Wednesday 8-12	Yes	No
5/8 Wednesday 12-4	Yes	No
5/9 Thursday 8-12	Yes	No
5/9 Thursday 12-4	Yes	No
5/10 Friday 8-12	Yes	No
5/10 Friday 12-4	Yes	No

What skills does your project require? (Please check all that apply)

Cleaning/Organizing

Painting

Outdoor work/landscaping

General repairs/construction savvy

Heavy labor (Ex: chopping wood, moving furniture, etc.)

Other…

Enter other…

Does your project include any of the following?

Heavy lifting

Heights

Recommended Clothing

Questions or Comments

I have read the Days of Caring: Agency Guidelines (see hyperlink below)

- Select -Yes

Days of Caring: Agency Guidelines

 

Submit

Leave this field blank