* Required

Student Namerequired

Student Email required

Organization Namerequired

Please list the name of the organization you are seeking approval to volunteer with.

Organization Address

Address 1required
Address 2
Address 3
Cityrequired
Staterequired
Region
Zip Coderequired (ex. 06108 or 06108-0809)
Country

Organization Contact Personrequired

Organization Contact (Phone)required

Organization Contact (Email)required

Organization URL

Please add the organization's web address or webpage.

Provide the mission of the organization/agencyrequired

Please detail the type of work that this organization/agency does for the community.required

In your own words, why should this organization/agency be added to the pre-approved list?required

Please enter your names below to digitally sign and submit this registration. Electronic signatures are legally binding and have the same meaning as handwritten signatures.

Electronic Signaturerequired