Organization's Information

Organization Name

Mailing Address:

City

State

Zip Code

Organization Phone Number

(xxx) xxx-xxxx

Organization Website

Mission statement (this is the mission statement of your organization, not for the program or project)

Executive Director/CEO/Superintendent Information

First Name

Last Name

Phone Number

(xxx) xxx-xxxx

E-Mail Address

Project Detail Information

Event/Project Title

Detailed description of the volunteer project

Project location (address)

Tasks for the volunteers

Skills needed for the volunteers

Dress Code

Expected environmental/safety concerns (example: volunteers should wear work gloves or bring work boots)

Is there insurance for project/activities and volunteers?

Please explain why there is no insurance

Project Schedule Information

Project start date

Start Time

Start Min

Start AM/PM

Project end date

End time

End Min

End AM/PM

Is this date / time flexible

If yes, please explain

Number of volunteers needed

Volunteer Age Requirement

Other Age Requirement

Colorado Springs Utilities equipment requested for the project (Colorado Springs Utilities volunteers must operate all Colorado Springs Utilities equipment)

Contact Information

First Name

Last Name

Phone Number

E-Mail Address

Authorization

I agree the information above is correct and the Executive Director/CEO/Superintendent of my orgranization has reviewed and supports the submission of this application.

Agree

Authorized name

Title

Contact Information