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. Check back often for news of upcoming projects!

First Name *

Last Name *

Age *

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.

Gender *

Ethnicity *

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:

Disabled Veterans Committee on Housing Lord Fairfax Community College AbbaCare Access Independence, Inc. Adult Care Center of the Northern Shenandoah Valley AIDS Response Effort (ARE) Alivia's Garden Alzheimers Association American Red Cross ARC of the NSV Big Brothers Big Sisters of Winchester, Frederick & Clarke Counties Blue Ridge Area Food Bank Blue Ridge Hospice Boys & Girls Club of Northern Shenandoah Valley CCAP Winchester CFW Foster Care Child Advocacy Network/Child Assault Prevention Project ChildSafe Center, CAC - Winchester Frederick Choices, Council on Domestic Violence - Page Co. CLEAN Dental Clinic of NSV Discovery Museum Division of Aging and Rehabilitative Services DSS – Frederick County DSS – Shenandoah County DSS – Winchester Edgehill Recovery Center Epilepsy Resources Foundation Faith in Action Families Reaching Out Group (FROG) Foundation for Rehabilitation Equipment Endowment (FREE) Foundation of the State Arboretum of Virginia Free Medical Clinic of NSV Good Samaritan Clinic of NSV Greater Winchester Area Parkinson’s Support Group Habitat for Humanity of Winchester-Frederick County Handley Regional Library Healthy Families NSV Help with Housing, Inc. Housing Choice Voucher Program Hurst Hospitality House – WMC Literacy Volunteers-Winchester Area Lord Fairfax Medical Reserve Corps NAMI – Winchester New Eve Ministries NW Works Parent Resource Center LLC ProjectAccept.org Saint Luke Community Free Clinic Shenandoah Area Agency on Aging Shenandoah Co. Free Clinic Shenandoah Memorial Hospital Shenandoah University Shenandoah Valley Community Residences, Inc. Shenandoah Valley Family Support and Development Center Shenandoah Valley Workforce Development Board, Inc. Special Love St. John’s Community Services Teens Opposing Poverty, Inc. TEENS, Inc. The Independent School of Winchester The Laurel Center Treatment Diaries United Way of NSV Valley Health Virginia Cooperative Extension Virginia Dept of Health Warren County Community Health Coalition WATTS Winchester Day Preschool & Child Care Center Winchester Rescue Mission Youth Development Center

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 *