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Montgomery County United Way

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Agency Request for Day of Caring

Agency Name

Agency Address

City

State

Zip

Agency Telephone

Primary Agency Contact

Position

Best form of contact By Phone By Email

Alternate Contact

Position

Best form of contact By Phone By Email

Do you own or lease your location Own
Lease

Other

Project Location Interior Exterior Both

Preferred Time for Volunteering Full-day Half-day Weekday Weekend

Nature of Activity Physical Labor Lighter Activity

Our Volunteers may have skills in Carpentry
Light Cleaning
General Repairs
Clerical
Painting
Craft/Artistic Projects
Gardening/Landscaping
Sorting/Organizing
Heavy Cleaning
Computer Related
Reading to Kids
Donation Drives

Detailed Project Description

Who will this project directly benefit children
seniors
crisis relief
families
disabled

Choose the MCUW Impact area this project mostly fits Moving People Out of Poverty
Helping People Cope with Challenging Situations
Facilitating Access to Affordable/Quality Healthcare
Prevention and Treatment for Drug/Alcohol Abuse
Providing Temporary Assistance During a Crisis

MCUW's Internal programs Success By 6 Hispanic Outreach

Our agency can contribute toward the supply cost of a DOC. yes no maybe

(include any in-kind donations)