Corporate/Group Volunteer interest form 2016 WORKPLACE & GROUP VOLUNTEERISM SURVEY Question Title * 1. Organization Name Question Title * 2. Organization Contact Person Question Title * 3. Contact Job Title Question Title * 4. Daytime Phone Question Title * 5. Email address Question Title * 6. Does your organization run a United Way workplace giving campaign? Yes No Unsure Question Title * 7. Has your organization participated in group volunteer projects in the past either through United Way or your own efforts? Yes No Question Title * 8. Does your organization offer paid volunteer time? Yes No Question Title * 9. Where are you interested in completing the volunteer project? Off-site at an agency partner At your own workplace Question Title * 10. What is the address for the starting point of any travel (or the address of your organization?) Question Title * 11. How far are you willing to travel to a project? 15 minutes 15-30 minutes 30-45 minutes 1 hour or more Additional Comments Question Title * 12. Number of Volunteers Question Title * 13. Do you have a particular date in mind for the project? Date / Time Date Question Title * 14. If you don't have a specific date secured, do you have a general time frame for the project? Question Title * 15. How long do your employees want to volunteer? 1 hour or less 2-3 hours half day full day Question Title * 16. Do you want the project to take place on a: Weekday morning or afternoon Weekday evening Weekend Question Title * 17. What kinds of projects are your employees interested in doing? Children & Youth Education Disaster & Emergency Services Hunger & Homelessness Civic & Community Financial Education open to anything All of the above Other (please specify) Question Title * 18. Does your company have a budget available for supplies needed to complete the project (e.g., paint, brushes, cleaning supplies, children's books, etc...) Yes No Unsure Other (please specify) Done