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:

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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