Please provide the following information and submit to United Way of Tarrant County:
Agency
Description of agency or program
Street Address
Address (cont.)
City
State
ZIP
Project Contact
Phone
Fax
E-mail (required)
PR/Media Contact
Phone
Fax
E-mail
Project description (be specific)
Project location
Impact area or specific  issue addressed (if applicable)	Kids Families Seniors    Crisis Relief Health   Early Learning and Development Child Abuse and Neglect Senior Isolation Adult Literacy Childhood Obesity
Number of volunteers needed:
Supplies needed
Availability of parking	Yes No
Availability of restrooms	Yes No
Other matters (confidentiality, appropriate dress, etc.)
Please submit form