FORMS

Summit County Stand Down

Donations and Volunteer Activities Report

Organization & Contact Information

Organization Name *

Contact Name *

Address *

Address Line 2

City *

State *

ZIP Code *

Phone *

Email *

Donated Items

Bulk Date

Description *

Date *

Quantity *

Unit *

Value per Item ($)*

Total Value ($)

Donated Items Total:

Volunteer Activities

Bulk Date

Note: Please include the time it takes you to submit this report as a volunteer activity. We recommend reporting a minimum of 15 minutes (0.25 hours) x $33.49 for your effort.

Activity Description *

Date *

Number of Volunteers *

Hours per Volunteer *

Minutes

Value per Hour ($) $33.49

Total Value ($)

Volunteer Activities Total:

The value per volunteer hour is based on the annual rate published by the Independent Sector.

Grand Total (Donated Items + Volunteer Activities):

Evidence / Receipts / Logs (optional)

Accepted: PDF, PNG, JPG, GIF, SVG. Max 10MB each.

Organization Logo (optional, recommended for sponsors)

Please upload your organization logo to appear on sponsor materials. PNG or SVG preferred.

Signature

Typed Signature *

Drawn Signature (optional)

This page is under construction. You may see our work come and go from time during testing and evaluation. Please do not make any entries on this form until further notice (when it appears).