Organization or Event Name:

Organization or Event Address:

Organization or Event City:

Organization or Event State:
AlabamaAlaskaAlbertaAmerican SamoaArizonaArkansasAustralian Capitol TerritoryBritish ColumbiaCaliforniaCanal ZoneColoradoConnecticutDelawareDistrict of ColumbiaFloridaForeign StateGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineManitobaMarylandMassachusettsMichiganMilitary - AmericasMilitary - EuropeMilitary - PacificMinnesotaMississippiMissouriMontanaNebraskaNevadaNew BrunswickNew HampshireNew JerseyNew MexicoNew South WalesNew YorkNewfoundlandNorth CarolinaNorth DakotaNorthern Mariana IslandsNorthwest TerritoriesNova ScotiaOhioOklahomaOntarioOregonPennsylvaniaPrince Edward IslandProvence of QuebecPuerto RicoQueenslandRhode IslandSaskatchewanSouth AustraliaSouth CarolinaSouth DakotaTasmaniaTennesseeTexasUtahVermontVictoriaVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyomingYukon Territory

Organization or Event Zip:

Description of Organization or Event:

Contact Name:

Contact Position:

Contact Phone:

Contact Fax:

Contact E-mail:

Organization or Event Web Site:

Volunteer Opportunity Title:

Volunteer Description & Responsibilities:

Start Date:

Time Commitment:
One Time
On-going
Annual

Please describe the time commitment: (e.g. Saturdays 10AM-12PM)

Volunteer Location:

County: (only if in New York State)
Albany Allegany Broome Cattaraugus Cayuga Chautaqua Chemung Chenango Clinton Columbia Cortland Delaware Dutchess Erie Essex Franklin Fulton Genesee Greene Hamilton Herkimer Jefferson Lewis Livingston Madison Monroe Montgomery Nassau Niagara Oneida Onondaga Ontario Orange Orleans Oswego Otego Putnam Rensselaer Rockland St. Lawrence Saratoga Schenectady Schoharie Schuyler Seneca Steuben Suffolk Sullivan Tioga Tompkins Ulster Warren Washington Wayne Westchester Wyoming Yates New York City

Volunteers may contact you by: (check all that apply)
E-mail
In Person
Telephone

Area(s) of Interest:
Advocacy & Human Rights Arts & Culture Children & Youth Community Improvement Disaster Response Domestic Violence Drug Abuse Faith Based Organizations Family Planning Gardening & Outdoors Holiday Volunteer Opportunities Homelessness Housing Hunger/Food International Job Skill Development Legal Literacy Media & Broadcasting Membership & Marketing Development Mentoring Services Nonprofit Organizations People with Disabilities Public Safety Senior Citizens Special Events

Your Name:

Your Phone:

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