UNITED WAY “DAYS OF CARING”
Agency/Organization Project Description Form
Friday, September 14 & Saturday, September 15, 2007
 
Agency Name:
____________________________________________________________________________________
Address:
______________________________________
Telephone
______________________________________
City/State/Zip
______________________________________
Email Address
______________________________________
Name of Project Coordinator
must be present on days of event:

___________________________________________________
Contact Name [if different from above]
& telephone:

___________________________________________________
Project Site Address
[if different from above]:

___________________________________________________

___________________________________________________

# of Volunteers needed & on what days: Max.: ___ Min.: ___
(Circle one day or both)

Fri., Sept. 14          Sat., Sept. 15


Skilled or specialized labor that may be needed: ____________________________________________

__________________________________________________________________________________

___________________________________________________________________________________

Volunteer Activity Description

Describe the 4 Hour project to be completed by volunteers:
(include specifics, i.e. agency’s goal, any plans for bad weather, etc.)
___________________________________________________________________________________

___________________________________________________________________________________

___________________________________________________________________________________

___________________________________________________________________________________


Supplies/Equipment

The agency is responsible for securing supplies and equipment for these projects. In some cases, companies may be able to assist you with purchases. If assistance is needed in obtaining equipment, please describe on an attachment.

Yes     No

Does your organization have liability insurance that would cover this event?

Yes     No


If not, please contact your insurance carrier.



___________________________________________________________________________
Agency Director Signature                                          Title                                            Date

“Days of Caring” is a great idea,
but we are not able to participate this year.
Please return this form by:
Friday, July 6, 2006
United Way of the Wabash Valley
Amy Williams
P.O. Box 3094
Terre Haute, IN 47803-0094
Telephone: 235-6287 Fax: 235-3901
joan.kutlu@unitedway.org
I would like to learn more about volunteer opportunities.
I would like to receive the United Way of the Wabash Valley newsletter.
I would like more information on estate planning and how to include a gift to United Way.
I have remembered United Way in my will/estate plan.