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Volunteer Hours Report - 2012
Required Required Question(s)
Required 1.

Please enter the information indicated below.

 

 
First Name:
Last Name:

Required 2.

 Date of Service (mm/dd/yyyy)

 

 
 

  • 50 characters left.
3.

Name of facility at which you volunteer.

 
 

  • 50 characters left.
Required 4.

Type of service

 
Facility Outreach
Special Event
Professional
Board Member
5.

If you are volunteering as a group, what is your group name?

 
 

  • 350 characters left.
6.

If you are volunteering in a group, how many people are in your group?

 
 

  • 50 characters left.
Required 7.

Did you spend personal money while volunteering?

 
No
Yes
8.

If you spent personal money while volunteering, how much did you spend?

(please do not use $ just enter the dollars and cents e.g., 12.50

 
 

  • 50 characters left.
Required 9.

What activities did you provide?

( you may select more than one)

 

 

 
One-on-one visits
bingo
manicures
bible studies
sing-a-longs
wheelchair assistance
game playing
Other  
Required 10.

How much time did you spend volunteering?

 

Record your time in hours and to two decimal places.  For example: If you volunteered for 2 hours and 20 minutes then you would record 2.33.  Or one and a half hours would be 1.50, 1 hour and 10 minutes would be 1.17 and so on...

__________________________________________________________

 Note: For groups be sure to multiply the number of people in the group by the time spent volunteering. 8 people in a group for 1.5 hours would be recorded as 8 X 1.5 = 12  You would enter 12

Please enter numbers only, no letters such as hrs, hours, etc...

 
 

  • 50 characters left.
11.

Additional comments or observations?

 
 

  • 1000 characters left.