Day of Action (formerly Community Care Day)
Volunteer Sign-up Form
Thank you for signing up to participate in United Way's Day of Action! Please complete the form below. Projects are available on a first come, first serve basis. Volunteers are required to wear closed-toe shoes for this event.

All projects will take place on Friday, June 6, 2008. United Way's Volunteer Connection will email your project assignment to you as soon as possible. Thank you!

I am signing up as: a group        an individual
Group Information:
Organization Name:
Organization Address:
Organization City:
Organization State:
Organization Zip:
Organization Phone Number:
Number of Volunteers:
Age Range of Volunteers:

Please provide the following information about each of the members of your volunteer group. 
If you have more than 20 volunteers in your group, please include their information in the comments section of this form.
  
First and Last Name Email Address Day-of-Event Phone T-Shirt Size

Would your company or organization like to sponsor United Way's Day of Action
by donating money and/or supplies to assist with the completion of the day's projects?
Yes   No   Not Sure - Please Call Me

Individual / Group Contact Person Information
First Name:
Last Name:
Address:
City:
State:
Zip:
Phone:
Email:
T-Shirt Size:
Are you at least 18 years old? Yes     No
Are you at least 21 years old? Yes     No

General Information
How did you hear about United Way's Day of Action? (please check all that apply)
Newspaper
Friend
My company / organization
Email from United Way
United Way Staff Member
Other  
 
Most projects will be completed between the hours of 8:00am and 4:00pm. Please check all times you are available:
8:00am - 12:00pm
12:00pm - 4:00pm
Other (please describe):  
 
Would you prefer to work a shift of four hours or eight hours?
Four Hours
Eight Hours
   
Which county would you prefer to volunteer in? Please check all that apply:
Montgomery County
Greene County
Preble County
   
Which neighborhoods are you available to volunteer in? Please check all that apply:
Centerville Dayton Dayton - Downtown Dayton - North
Dayton - West Dayton - East Dayton - South Eaton
Englewood Fairborn Huber Heights Kettering
Riverside Trotwood Xenia Yellow Springs
Other (please describe):  
   
Which skills are you interested in using as a volunteer? Please check all that apply:
Painting Carpentry Child Care
Cleaning Clerical Friendly Visiting
Construction Crafts Electrical
Food Preparation Heavy Lifting Landscaping
Basic Maintenance Plumbing Sorting
Other (please describe):  
   
Please list any special skills that members of your group may have:
   
Please list any physical limitations that you or members of your group may have:
     
If you have a preferred project, please list the name and location below:
     
Additional notes and comments:
 
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