Please provide the following contact information:

First Name
Last Name
Title
Organization
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Work Phone
FAX
E-mail
URL

What is your agency's mission statement?

Briefly describe your agency and the work that you do:

Minimum age to volunteer with your agency:

No minimum age
14 years old
16 years old
18 years old
21 years old
Other

Describe the volunteer opportunities available for young people:

Describe any special knowledge, skills or abilities needed:

Is there a volunteer training program and/or orientation program for volunteers?

Yes No

If yes, please describe:

Please include any other information that you would like to share regarding your agency's volunteer program: