Organization Website

Contact Name

Phone

Email

Volunteer Activity Description

Skills and Abilities Required

What community or organizational need will the volunteer help meet?

	Number of Volunteers Needed
	Hours per week needed
	Start Date
-- Ongoing One-time	Is this an ongoing or episodic (one-time) assignment?
	Location of Volunteer Activity
-- Yes No	Is training provided or required by your organization? If yes, please explain.
-- Yes No	Will this activity require handling confidential information? If yes, please explain.
-- Yes No	Will volunteer work with children or special needs populations?

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