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VOA Volunteer Service Hours Form
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Email
*
Your email
Last Name
Your answer
First Name
Your answer
Address 1
*
Your answer
Address 2
Your answer
City
*
Your answer
State
*
Your answer
Zip Code
*
Your answer
Phone (area code + 9 digit number)
*
Your answer
Date of service
*
MM
/
DD
/
YYYY
Total hours served (e.g. 1, 1.5 , 2.25, etc. to closet quarter hour)
Your answer
Program (select one)
*
Unity House, Family Emergency Shelter, Louisville, KY
Freedom House, Women's Addiction Recovery Services, Louisville, KY
Freedom House, Women's Addiction Recovery Services, Manchester, KY
Liberty Place, Men's Addiction Recovery Services, Louisville, KY
Supportive Services for Veterans (SSVF)
Supportive Services for Families
VOA Health: Outreach and Prevention, Louisville, KY
VOA Health: Determine Health, Louisville, KY
VOA Development Disabilities Services, Indiana
VOA Developmental Disabilities Services, Tennessee
Senior Housing, Louisville, KY
Restorative Justice, Louisville, KY
Restorative Justice, London, KY
Administration
Activity Description
Children's Services (tutoring, childcare, etc.)
Serving meals
Recreational activities
Restorative Justice services (mediation, outreach)
Special events (birthday parties, holiday parties, baby showers, health fair, etc.)
One-time group project (indoor/outdoor program facility cleanup and/or organizing)
Virtual service (making greeting cards, etc.)
Collection project (school supplies, canned goods, maternity items, personal hygiene items)
Resource kit assembly project (personal hygiene kits, condom kits, etc.)
Clerical Support
Other
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Type of service
Group volunteer (participated in a group project with my business or organization)
Individual community volunteer - adult
Individual community volunteer - minor
Intern/Practicum Student
Service Learning Student
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