IMPACT Volunteer Request Form
Do you represent an agency in the Houston community or are you a JLH volunteer?
Representative from Houston agency
JLH Project Chairman
Agency or Community Project Name
Description of Opportunity (Please describe what the volunteers will be doing)
Minimum number of volunteers needed
Maximum number of volunteers needed (Please leave blank if there is no minimum)
Is this opportunity completed in person or virutally/remotely?
Date (Please leave blank if the work is done remotely when the volunteer is available)
Start Time (Please leave this blank if the work is done remotely when the volunteer is available)
End Time (Please leave this blank if the work is done remotely when the volunteer is available)
Address (If the opportunity is in person)
Is it possible that this could be a recurring opportunity? If so, what can you share about future dates?
Does the JLH volunteer need to sign up directly with the agency in addition to signing up through JLH's member portal? If so, please list the website and the deadline date?
What is required of the volunteer prior to the shift (background check, immunization records, training, etc.)?
What is required of the volunteer during the shift?
Are the above requirements supplied by the agency, JLH or the volunteer?
How many people are projected to attend the shift/event (excluding volunteers)
Are JLH volunteers the only people participating in this opportunity?
I am not sure.
Are hand washing facilities available to volunteers?
Will the agency be providing hand sanitizer to volunteers and others who are present?
Will event participants, employees and/or volunteers be required to wear masks?
Does the physical space at which the event will take place allow for social distancing?
FOR JLH PROJECT CHAIRMEN ONLY: What is the estimated cost per volunteer? Is this cost already captured in the project's budget?
Is there anything else you would like to share?
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