Illinois COVID-19 Volunteer Reporting

The following survey will be utilized by the State of Illinois to collect aggregate volunteer data during the COVID-19 response effort. The data may be used at a later date in any application for disaster funding. Please continue to submit surveys on a weekly basis as your aggregate data increases.

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* 1. Organization Name:

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* 2. County Served (if multiple counties were served, please select "multiple counties" and list them in the box provided)

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* 3. Primary Contact Name:

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* 4. Primary Contact Email:

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* 5. Primary contact phone number:

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* 6. Number of total volunteers utilized for COVID-19 response:

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* 7. Number of hours served by volunteers during the COVID-19 response:

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* 8. Number of people served:

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* 9. Please list the volunteer activities conducted during the COVID-19 response.