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SoS Member Agency Application
Name of Agency
Contact Person
Phone
Email
Address Line 1
Address Line 2
City
State
Please select...
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District Of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Puerto Rico
Virgin Island
Northern Mariana Islands
Guam
American Samoa
Palau
Postal Code
Secondary Contact Person
Secondary Contact Phone
Secondary Contact Email
Proposed Project
Minimum number of volunteers needed
Maximum number of volunteers needed
Will your project be indoor and/or outdoor?
Indoor
Outdoor
Date you are interested in participating
September 26
October 24
November 21
December 5
January 23
February 20
March 27
April 24
Do you have any additional comments or questions?
I understand that if selected to participate in SoS, my agency will have a minimum of one staff member on site.
I agree that we will provide an explanation of our agency to students during the project in order to offer an educational and enriching experience for the volunteers.
I agree that it is my agency’s responsibility to provide any supplies needed for this service project.
I agree that the proposed project will fill approximately two to three hours of the volunteers' time. If the project is completed early, another project will be available.
I agree that the student organization, SERVE, has the right to cancel the service project at any time due to inclement weather conditions.
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