Volunteer Request Form

(Pink Forms Are Required)

Contact Information

Title of Event or Project:

Agency Name:
If your agency is not listed, fill out the Agency Information Form.

Type of Opportunity (Check all that apply)
Individual (1-3 volunteers)
Group (3-10 volunteers)
Either

Number of Volunteers Needed
Minimum Maximum

Duration of Opportunity (Check all that apply)
One Time (1 day to 2 weeks)
Short Term (2 weeks to 3 months)
On-going (3+ months)
School Year Only (August-May)
Flexible

Days/Times Volunteers are Needed (Example Sun 8-10am, Mon 3-6pm)
Sunday Monday Tuesday Wednesday Thursday Friday Saturday

Are these days flexible?
Yes No
Are these times flexible?
Yes No

Project Dates
From To
Does this project occur regularly?
Yes No
If yes, when will this program occur again?

Description of Project

Project Description (Please be as specific as possible):
Skills/Experience/Training Needed (i.e. CPR, Computer Skills, Major, etc.):
Job/Project Location (If different from above): Directions to Job/Project from WIU: Is the Job/Project Near a Go-WEST Route, if so which one? (Routes can be found online at: Go-WEST or by calling Go-WEST at 309-298-3353):

Training and Supervision

Is Training Provided:
Yes No

By Whom:
Date/Day and Time: Location:
Type of Supervision Provided (Daily meeting, monthly meeting, 10 min. daily..): Supervisor's Name: Phone #:

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