UWHCM Day of Action Project Application Form

Day of Action Project / Drive Request

Projects should completed between 10:00 a.m. and 3:00 p.m. Friday, September 12, 2025.
Project Guidelines:
- Project must be for a nonprofit 501(c)(3), local school system, or a local government agency located in Henry County or Martinsville, VA.
- The project must meet a real need at the agency.
- Projects to benefit vulnerable community members (such as home repair for an elderly resident, or public beautification) will be considered, but are at the discretion of the Executive Director and/or UWHCM Board of Directors for approval.
- Supplies and materials are identified, and a plan is in place to secure items.
  - Occasionally, but in rare instances, a UWHCM volunteer team or sponsor(s) may be able to provide supplies. If you need assistance with supplies, please let us know in detail on your application below.
- Application Deadline is August 8, 2025.
- Please forward questions to Rebecca@UnitedWayofHCM.org
Application date

MonthDayYear
Date
Organization Details
Name of the Organization*
EIN / Tax ID*
Day of Action Project Manager / Supervisor*

First NameLast Name
Phone Number*

Area CodePhone Number
Email*
example@example.com
Organization Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Website URL
Project Information
Project Title*
Start Date*

MonthDayYear
DateHourMinutesAM/PM Option
End Date*

MonthDayYear
DateHourMinutesAM/PM Option
Project Request Type*

Outdoor Volunteer ProjectIndoor Volunteer ProjectItem / Need Drive
Project Physical Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Provide a brief description of the project/drive*
What materials will you provide?*
If none, please put N/A.
What materials will the volunteers need to provide?*
If none, please put N/A.
Describe any limitations our volunteers should be aware of, for example: no public restrooms, limited restroom access, wheelchair accessibility, adult-only facility, dress code, etc.*
If none, please put N/A.
How many volunteers will you need to complete this project within five hours?*
Volunteer teams traditionally range from groups of 3-15 volunteers, depending on your facility's capacity. If you are unsure of your project needs, please put zero "0". We will contact you to help recommend a volunteer count.
Will you provide liability insurance to cover volunteers?*

YesNo
Does your agency have restrictions regarding media, photos, video being taken at the project or drive location?*

YesNoOther
Does your project require additional funding?*

YesNoOther
UWHCM mobilizes our community to advance youth opportunity, financial security, and a healthy community. Can you please briefly elaborate on how your project aligns with our mission? Alternatively, please provide the benefits that this project offers both volunteers and the Martinsville-Henry County community.*
Please provide any additional information you would like for us to know below.
Authorized Signature (Day of Action Project Manager / Supervisor)
Please Note: UWHCM will begin soliciting volunteer participants for your requested project upon project approval. Your organization will be notified if your DOA project or drive request is approved or denied no later than August 12, 2025. If you have not heard from us by that time, please contact Rebecca at Rebecca@UnitedWayofHCM.org. Thank you.
Should be Empty:

Day of Action Project / Drive Request

Organization Details

Project Information