Community Engaged Leader Event Information Form

Please submit this form NO LATER than the last day of the month before the event occurs.


Event Name: 

Date of Event:  mm/dd/yyyy

Event Time:  to

Time Volunteers Should Arrive (if different than above): 

Event Location (full address): 

Volunteer Meeting Location (if different than above): 

Brief Description of Event, Including the Duties of the Volunteers:

Approximately How Many Volunteers Do You Need? 

Any Other Needed Info:

Your Contact Information:




Upon the successful completion of this form, you will be automatically directed to the Community Engaged Leaders page. You will contacted regarding this form within 2 to 3 business days.