2025 Day of Action & Day of Caring

Individual or Volunteer Group Contact Info

Company or Individual's Name

Volunteer Coordinator's Name

Number of volunteers promised for project

Volunteer Name(s)

Is your group willing to be split up to work on different projects?

- Select -Yes No

If yes, how many groups?

Address

Coordinator's Phone

Coordinator's Cell Phone

Coordinator's Email Address

Project Interests (Please select the following tasks that interest your group)

- Select -Painting Friendly Visit Heavy Lifting Carpentry Construction IT Support Neighborhood Clean-up Cleaning Basic Maintenance Landscaping Feeding Seniors/Homeless Coordinating Hygiene Drive Serving Hot Meals to Seniors Reading to Children Anywhere Needed Other (Please List Below)

Describe your individual or group's volunteer interests and skills

Indicate any physical limitations

Additional Info? Have you worked somewhere in the past and enjoyed it?

Are there any restrictions on what your participants can do? Allergies, no heavy lifting, indoor/outdoor, etc.

Shirt Size(s)

Questions or Comments

United Way Photo & Liability Release

- Select -I/We Agree I/We Do Not Agree

Important!

Submit

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