CLOSE   10th Annual Day of Caring Saturday, September 11, 2010 On-Line Agency Project Application Applications Due September 1, 2010     You MUST Print this Page to Sign BEFORE You hit the "Send Mail!" Button at the Bottom of the Page.  You may instead Download the PDF or Word Doc (previous page), Print and Manually Fill in the Form. Mail/Deliver or FAX the Signed Form to the United Way Office at the following: United Way of Pike County Mail: PO Box 806, Milford PA 18337 Office: 201 West Harford Street, Milford PA 18337 Phone: (888) 306-6963 or (570) 296-9980 Fax: (570) 296-5571 Email: uwpc@ptd.net     AGENCY CRITERIA Participating Agencies must have 501(c)(3) status. Event is held rain or shine. Please provide inside project in case of rain. Agency must supply all materials, tools and/or permits needed for project. Example: paint, brushes, drop clothes, wood chips, plants, rakes, shovels. Agency is to provide simple lunch for the volunteers. Example: pizza, sandwiches, soft drinks, water. Volunteers will arrive by 9 AM and projects are to be completed by 3 PM. Please Complete One Form Per Project PLEASE RETURN FORMS AS SOON AS POSSIBLE DEADLINE TO APPLY IS ON OR BEFORE SEPTEMBER 1, 2010   United Way of Pike Annual Day of Caring - Saturday, September 11, 2010 2010 AGENCY PROJECT APPLICATION Agency Name Contact Person Phone E-Mail Address Line 1 Address Line 2 City State Zip   SITE Site Location (if differs from agency) Site Phone (if differs from agency)   VOLUNTEERS Description of Volunteer Oppurtunity (be specific): No. of Volunteers Needed Adult Youth (Ages 14-17) Skills Needed Will Training be Provided? No Yes If Yes, By Whom: Will Volunteers be Working Directly with Clients? No Yes   If Yes, Description of Clients:   Identify at least One Person who will be On Site During the Work   TRANSPORTATION Will your agency provide transportation from Delaware Valley High School to the work site and back? (bus/van, designated driver, organized carpool) No Yes   Please provide complete directions and mileage from the school: Use the open text box below and/or the links below (Yahoo Directions) to send them by email. Be sure to include any special instructions in the open text box below e.g., use side entrance. From Delaware Valley High School at 252 US 6 and US 209, Milford, PA 18337 How to Use and EMail Yahoo Directions: Enter Your Agency Address in "A" Address for the High School should already appear in "B" Choose "Reverse Directions" link near the "Go" button Select "Send to" Directly Above Map Enter uwpc@ptd.net Enter Agency Note in Comments -OR- Select "Printable Version" Directly Above Map Fax/Mail or Print to a PDF and EMail to Us Approximate Milage:   OTHER Does your agency have liability insurance that covers volunteers working for your agency? No (Volunteers Need to be Covered by Thier Own Insurance) Yes Please note: Available volunteers may be limited due to lack of insurance. Describe any volunteer recognition that will happen at your site on the Day of Caring?   Please indicate the name/phone of the staff member who will be acting as your Day of Caring Coordinator? Name   Phone Emergency Phone   ~ IF USING THE ON-LINE FORM ~ PRINT FROM BROWSER BEFORE "SUBMIT MAIL!"   First Click Here to Print Page and FAX/Mail/Deliver to UWPC         CLOSE