Agency Project Submission Form

Agency Name

Contact First Name

Contact Last Name

Phone

Email Address*

Project Name

Project Description

Project Address (include City, Zip)

Project takes place:

All Day
Morning (8:30 AM - 12:00 PM)
Afternoon (1:00 - 5:00 PM)

Materials and Items Volunteers Must Provide (be specific!)

Project Level

Easy
Medium Difficulty
Difficult

The following is applicable only when MAJOR renovations or demolition is requested.

Approved by the Board on (date)

Submit only one form per project. If you have questions, please contact Laura Lawson at (434) 455 6900. Thanks!