WCWI Volunteer Interest Form

Thank you so much for volunteering your time to support your community.

The purpose of the Washington County Wellness Initiative is to strengthen and transform the public health infrastructure through community-based action. There are currently eleven (11) workgroups within the WCWI working to attain our goals and nurture our community. The success of the coalitions and the WCWI initiative is a result of local partners working together. Please join us in this effort to create healthy communities by becoming involved in and/or offering resources for any of the following areas:

Please check the boxes that are of most interest to you!

Question Title

* 1. Please enter your contact information and we will use it to contact you within 7 days.

Name

Community Sector

Address

Address 2

City/Town

ZIP Code

Email Address

Phone Number

Question Title

* 2. Health Care Access

I would like to be a member of this committee

I am interested in doing research about health care access in other communities

I am willing to research and help with grant writing

I have other ideas, or resources such as:

Question Title

* 3. Affordable Housing

I would like to be a member of this committee

I am interested in doing research about affordable housing efforts in other communities

I would like to help with transitional housing programs

I would like to become involved with Family Promise

I am willing to research and help with grant writing

I would like to become more involved with Habitat for Humanity

I am interested in developing a housing rehab program for Washington County

I have other ideas, or resources such as:

Question Title

* 4. Transportation

I would like to be a chairperson

I would like to be a member of this committee

I am interested in volunteering to repair cars

I am willing to research and help with grant writing

I am interested in helping with Church Women United’s Car Repair Program by raising funds

I am interested in developing a car donation program

I have other ideas, resources such as:

Question Title

* 5. Mental Health

I would like to be a member of the Washington County Association for Mental Health

I am willing to research and help with grant writing

I have other ideas, or resources such as:

Question Title

* 6. Lifestyle/Preventative

I would like to be a member of this committee

I am willing to research and help with grant writing

I am willing to help with Safe Routes to School

I am willing to work on and develop nutrition/physical activities for youth

I would like to work on and develop physical activities/nutrition policies

I have other ideas, or resources such as:

Question Title

* 7. Suicide Prevention

I would like to be a member of this coalition

I am interested in becoming a QPR instructor

I am interested in participating in a support group for survivors

I am willing to help with a public awareness campaign

I am willing to research and help with grant writing

I have other ideas, or resources such as:

Question Title

* 8. Poverty Alleviation

Family Promise

Transitional Housing Program

Project Prom

I am interested in helping develop Individual Development Savings Account for low-income individuals

I am interested in working on and developing policy changes

I am willing to research and help with grant writing

I would like to help with workforce development

I have other ideas, or resources such as:

Question Title

* 9. Washington County Anti-Drug Network

I would like to be a member of this committee

I am interested in working with the Youth Koalition

I would like to help with media and community awareness

I am willing to research and help with grant writing

I am interested in learning more about how to prevent drug and alcohol abuse in Washington County

I would like to help families with Christmas adoptions or other needs

I have other ideas, or resources such as:

Question Title

* 10. Hispanic Outreach

I would like to get involved with Casa Hispana

I would like to help with media and community awareness

I would like to help with grant writing and fundraising

I have other ideas, or resources such as:

Question Title

* 11. Other Resources I Have To Offer WCWI

Accounting

Training/Education

Communications

Computer/Technology

Data Collection/Analysis

Evaluation

Event Planning

Graphic Design/Web Design

Legal

Marketing/Advertising

Photography

Public Policy/Laws

Public Speaking

Social Media

Strategic Planning

I have other ideas, or resources such as:

Thank you again for offering your time and resources to support WCWI's efforts to nurture our community!