Volunteer Organization Information Form

Note: All bold items are required.

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Name of Organization:

Street Address:

Mailing Address:

City:   State: ... 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 Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming   Zip:

County: ... Allen Anderson Atchison Barber Barton Bourbon Brown Butler Chase Chautauqua Cherokee Cheyenne Clark Clay Cloud Coffey Comanche Cowley Crawford Decatur Dickinson Doniphan Douglas Edwards Elk Ellis Ellsworth Finney Ford Franklin Geary Gove Graham Grant Gray Greeley Greenwood Hamilton Harper Harvey Haskell Hodgeman Jackson Jefferson Jewell Johnson Kearny Kingman Kiowa Labette Lane Leavenworth Lincoln Linn Logan Lyon McPherson Marion Marshall Meade Miami Mitchell Montgomery Morris Morton Nemaha Neosho Ness Norton Osage Osborne Ottawa Pawnee Phillips Pottawatomie Pratt Rawlins Reno Republic Rice Riley Rooks Rush Russell Saline Scott Sedgwick Seward Shawnee Sheridan Sherman Smith Stafford Stanton Stevens Sumner Thomas Trego Wabaunsee Wallace Washington Wichita Wilson Woodson Wyandotte Statewide

Brief Description of Organization:

Contact First Name:   Contact Last Name:

Contact Position:   Contact Phone:

Contact Email:

Alt. Phone:   Fax:

Web Address:

Service Opportunities:

* Organizations can only be listed in the database if they DO NOT discriminate against potential volunteers based on race, color, religion, sex, sexual orientation, marital status, age, national origin, political belief or physical or mental disability.
* Listing in the database is provided as a free service by the Lieutenant Governor’s office.
* Each organization is responsible for posting/updating your organization as necessary. Your organization and/or its opportunities then go through an approval process before being placed on the site.