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Give 5 Non-Profit Application Form

  1. Give5

  2. Is this the same address where the Give 5 class is to be delivered? If no, please indicate address below.*

  3. Is your organization located within Greene County?*

  4. Executive Director

  5. Volunteer Coordinator

  6. Alignment With Community Priorities*

    It is the City’s intention to focus the Give 5 program toward non-profits whose mission aligns most closely with the following community priorities. Please indicate which of the following community priorities your organization aligns (select all that apply):

  7. Note: It is possible that, if the Give 5 program is successful, additional “tracks” could be created that are focused on other priorities in addition to the ones listed above.

  8. Your Organization’s Volunteer Needs

    If your organization is selected to participate in the Give 5 program, a representative from Give 5 will work with you to outline your intended “hosting time” when each Give 5 class is delivered to your organization. Your organization will likely have 20-30 minutes with each class. The class size will be no more than 25 members. It is the City’s intention that your “hosting time” be informative, engaging and, if possible, interactive. We encourage you not to place the class in a room and “talk at them.” This is your organization’s opportunity to put your best foot forward to explain what you do and any volunteer opportunities you have that might appeal to the class members.

  9. What special skills/talents are you seeking in your volunteers, and approximately how many hours per month are you needing volunteers in each skill/talent category?

  10. Within the list above, which three are your organization’s areas of greatest need?*

  11. The Process

  12. All members of each class will be provided a binder of information about each of the non-profit organizations they will be visiting. Do we have your permission to include in the binder any information you provide on this form?*

  13. If selected to participate, your organization’s executive director and volunteer coordinator will be emailed a document providing summary demographic information about the class that will be visiting you next. This document will not include personal information about the members of the class, but summary information will be provided.

  14. It is the City of Springfield’s intention to track the effectiveness of the Give 5 program over time. Selected non-profits will be asked to provide statistical information (number of volunteer hours worked per Give 5 volunteer) and a brief anecdotal report via email every six months. If selected, does your organization commit to providing this information every six months? *

  15. Signature

  16. Via my electronic signature below, my organization is applying to participate in the City of Springfield’s Give 5 program.

  17. Thank you for your organization's interest in hosting a class day! A coordinator will be in touch with you soon. Give 5 is brought to Springfield-Greene County by the Greene County Senior Citizens' Service Fund and the City of Springfield.

  18. seniorsfund

  19. Citylogo

  20. Leave This Blank:

  21. This field is not part of the form submission.