Career Services: Volunteer Agency Request Form

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Volunteering / Community Service:
Agency or Program Needing Volunteers?

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Volunteer / Community Services

Volunteer Fair: Agency Registration

Agencies / Programs interested in obtaining volunteers must submit the following form. Please complete all requested information and select the "submit" button at the bottom of the page to complete your registration. If you have any questions, please contact Vicki Hardin at 678-839-6431 or vhardin@westga.edu

Agency*
Physical Address *		City*		State*
Mailing Address *
City*		State*			Zip*
Website*

Contact Name *		Title*
Email*
Phone*		Fax*

Please check up to three agency service areas and indicate your primary area if more than one in the space below:*
	Animals		Housing
	Arts and Culture		Older Adults			Primary*
	Civil Rights / Law		Recreation
	Disabilities		Women
	Youth		Poverty / Hunger
	Environment		Education
	Health Services

Please describe the purpose or mission of your agency *

Please provide any other agency information we should know about.*

Please provide a brief description about what a volunteer may do at your agency. *

**Required Fields**

"A world of opportunity for you . . . Career Web"
Department of Career Services
University of West Georgia
355 Parker Hall
Carrollton , GA 30118
678.839.6431
FAX: 678.839.6432

Career Services is a Department within the Division of Student Services.