Serve Indiana Employer Volunteer Challenge: Employer Registration Form Survey

Employer Registration

Thank you for registering for Serve Indiana's Employer Volunteer Challenge, taking place from April 1-May 31. After submitting the form below, you will receive an email confirmation that includes the information provided, along with a request for your logo if you would like it included in the Serve Indiana's Employer Volunteer Challenge promotional messages.

NOTE: Individual employees will not register for the Challenge. Employers will register and have one point of contact who is responsible for submitting volunteer hours for all participating employees for your organization.

1.Employer Name(Required.)

2.Type of Company(Required.)

3.Address
Note: If your organization's headquarters is outside of Indiana, you may provide that address. However, please ensure that only Indiana employee volunteer hours are being counted for the Employer Volunteer Challenge.(Required.)

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

4.Please select the County associated with your organization's address.
Note: If your organization's address is outside of Indiana, please select "Other."(Required.)

5.If you selected "Other" for Question 4, please provide the name of the County associated with your organization's address.(Required.)

6.Would you like to be included in any upcoming publicity?(Required.)

7.If you would like to be included in social media publicity, please include your organization's social media accounts that can be tagged by Serve Indiana (Twitter, Instagram, Facebook, etc.).(Required.)

8.Total Number of Employees(Required.)