Community/Days of Service

Community volunteer programs improve the quality of life for the community by engaging groups of community members in valuable days of service projects. VAC will host several large-scale days of service each year. These service events provide the opportunity for individuals and groups to make a difference in just one day. Gather a team of co-workers, family and friends, or come on your own to make a big difference.

Subject *

First Name *

Last Name *

Age *

Gender *

Phone Number *

Alternate Phone Number

Email Address *

Street Address *

Street Address (cont'd)

City *

State *

Zip Code *

Do you have health limitations that could affect your volunteer assignment? If YES, please explain.

Level of Education *

Are you currently employed? *

Place of Employment

Do you have your own transportation? *

Hours Available per Week *

Days Available

Sunday Monday Tuesday Wednesday Thursday Friday Saturday

Preferred Times to Volunteer

Early Morning Mid Morning Afternoon Evening

Skills

Active Listening Bilingual/Multilingual Bookkeeping/Budgeting Clerical/Data Entry Computer/Web Design Driver Education/Training Fundraising Healthcare Provider Mentoring Receptionist/Phone Skills Recreation Recreational Support

Other

Languages Spoken

English German Spanish

Other

Interests

Child Care Children Clerical Support Counseling/Support Elderly Fundraising Healthcare Provision Healthcare Settings Marketing/Publicity Patient/Family Support Respite Care Transportation Youth

Other

Agencies to Volunteer For

If you are interested in volunteering for a particular organization, please indicate your preference/s below:

AbbaCare, Inc. Access Independence, Inc. Adult Care Center of NSV, Inc AIDS Response Effort Alivia's Garden Alzheimer's Association ARC of NSV Big Brothers Big Sisters of WFC Blue Ridge Area Food Bank Blue Ridge Hospice Boys and Girls Club of NSV CCAP Winchester ChildSafe Center - CAC Choices, Council on Domestic Violence CLEAN, Inc. Community Foundation of NSV Community Prenatal Access Concern Hotline Dental Clinic of NSV Dept. of Social Services - Frederick County Dept. of Social Services - Shenandoah County Dept. of Social Services - Winchester Division of Aging and Rehabilitative Services (DARS) Edgehill Recovery Center Epilepsy Resources Foundation Faith in Action Families Reaching Out Group FROG Family Promise of Shenandoah County Foundation of the State Arboretum of VA FREE – NSV Good Samaritan Clinic – Martinsburg Greater Winchester Area Parkinson's Support Group Habitat for Humanity Handley Regional Library Healthy Families of NSV Healthy Families Shenandoah Highland Food Pantry, Inc. Housing Choice Voucher Program I'm Just Me Movement Literacy Volunteers Lord Fairfax Community College Lord Fairfax Community College – NSV Adult Education Lord Fairfax District Medical Reserve Corps NAMI-NSV New Eve Maternity Home NSV Substance Abuse Coalition NW Works, Inc. Page Free Clinic ProjectAccept.org Resolutions, Inc. Response, Inc. Shenandoah Area Agency on Aging Shenandoah Co Free Clinic Shenandoah University Shenandoah Valley Community Residences, Inc. Shenandoah Valley Discovery Museum Shenandoah Valley Family Support and Development Center Sinclair Health Clinic Soles4Soles Special Love, Inc. St. John's Community Services St. Luke Community Clinic Teens Opposing Poverty, Inc. TEENS, Inc. The Independent School of Winchester The Laurel Center Treatment Diaries United Way of NSV Valley Assistance Network Valley Health System Valley Workforce Virginia Dept. of Health Virginia Employment Commission Virginia Tech. Extension Warren County Community Health Coalition WATTS – Winchester Area Temporary Thermal Shelter Winchester Area NAACP – Unite 7127 Winchester Day Preschool & Child Care Center Winchester Rescue Mission WMC Hurst Hospitality House Youth Development Center, Inc.

Additional Information

What type of volunteer connection are you interested in finding?

Short-term/episodic opportunity Long-term/ongoing opportunity Special Events Board Member

Please select a particular age category where you have special interest.

Children Youth Senior Citizens

Travel: Several Organizations are outside of the Winchester/Frederick County area. Are you willing to travel to surronding counties to volunteer?

Principal Employment Experience *

How Did You Learn About This Opportunity? *

Why Are You Interested in Volunteer Services? *

Additional Information That Would be Helpful in Finding a Meaningful Volunteer Connection for You

Date Submitted *