Volunteer Hours Submission Form
Thank you for your dedication to Headwaters Relief Organization! Your volunteer hours are vital to helping us track our impact, plan future relief efforts, and recognize the incredible contributions of our team. Please provide your volunteer hours as accurately as possible based on your recollection. Every hour you report helps us continue supporting communities in need and ensures your efforts are properly acknowledged.
Date of Submission
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Volunteer Legal Name
*
First Name
Last Name
Volunteer Email
*
example@example.com
Volunteer Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Is this your first time volunteering with Headwaters Relief Organization?
*
Yes
No
What was your role?
*
Volunteer
Board Member
Select the board member activities completed:
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Board Meeting
Gala
Golf Tournament
Fundraiser
Relief Trip
Volunteering Trip
Other event
Select the volunteer activities completed?
*
Fundraiser
Relief Trip
Volunteer Event
Other
Board Meeting
Date of board meeting
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Board meeting location
*
Hours donated
*
Volunteer Event
Event/Project Details
*
Event Name
*
Location
*
Date of Service
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hours worked - Preparation
*
Hours worked - Travel
*
Hours worked - On-site service hours
*
Hours worked - Post event
*
Team Lead/Supervisor (if any)
First Name
Last Name
Gala
Date of gala
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Gala location
*
Gala name
*
Hours donated
*
Golf Tournament
Date of golf tournament
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Golf tournament location
*
Golf tournament name
*
Hours donated
*
Fundraiser
Date of fundraiser
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Fundraiser location
*
Fundraiser name
*
Hours donated
*
Relief Trip
Date of relief trip
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Relief trip location
*
Relief trip name
*
Hours donated
*
Volunteering Trip
Date of volunteering trip
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Volunteering trip location
*
Volunteering trip name
*
Hours donated
*
Did you have to travel for this trip?
*
Yes, I traveled within my state
Yes, I traveled outside of my state
Yes, I traveled abroad (outside of the U.S.)
No, I did not travel for this trip
Other
Other event
Date of other event
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Other event location
*
Other event name
*
Hours donated
*
Additional Information
Volunteer Tasks/Activities (Select all that apply. If Other, please specify)
*
Disaster Response/Field Work
Logistics & Operations
Administrative Support
Fundraising & Community Outreach
Education & Training
Media/Documentation
Board Meeting
Other
Skills or Certifications (If applicable)
For example, CPR, First Aid, medical or nursing skills, language skills, or other certifications used during volunteering.
Rate your experience with Headwaters Relief Organization.
*
1
2
3
4
5
Do you have any comments or suggestions?
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Signatures
I understand and accept that my electronic signature will be as valid as a handwritten signature and considered original to the extent allowed by applicable law. Please see the Consumer Consent Disclosure at https://www.jotform.com/consumer-consent-disclosure/
Volunteer Legal Name
*
First Name
Last Name
Volunteer Signature
*
Date of Signature
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Submit
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