Day of Caring Project Application | United Way Blackhawk Region

DAY OF CARING PROJECT APPLICATION

Primary Contact's Name

Agency / Organization

Email

Phone

Address

Address 2

City

State

ZIP Code

Project Information

Is the project address different than above?

Yes

No

Address

Address 2

City

State

ZIP Code

Number of hours to complete project

Approximate number of volunteers needed

Description of Project

Materials Needed:

Please provide an inclement weather plan for your project

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

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