Online Agency Application Form

If your organization wants to use RSVP for volunteer placement, fill out this form.

Use this form to enroll your organization in RSVP's volunteer placement.

Organization Info

Organization (Required)

Name of the organization

Type (Required)

Please check which best describes your organization

Public or Private Non-Profit Organization
Nonprofit or For-profit Duly Licensed Proprietary Health Care Facility (Nursing Home, Assisted Living)
Governmental Public Agency
Other

Other

If you checked "Other" above, please describe your organization.

501(c)(3) Status

If applicable, how long has your organization had 501(c)(3) Status?

Chief (Required)

Name of Director/Owner/CEO of your Organization

Contact

Contact (Required)

Name of Volunteer Manager/Contact Person

Mailing Address (Required)

Street, City, State, ZIP

Physical Address

If different than your mailing address.

Phone (Required)

FAX

Your E-Mail Address (Required)

Web Site

Volunteers

Accessibility (Required)

Is the building where your office is located Handicap Accessible? (Note: Answering NO to this question does not mean anything negative with RSVP. We just have to have this information for our records.)

Yes
No

Needs (Required)

Identify what you will want RSVP volunteers to do for your organization.

Mission (Required)

What is your organization's Mission Statement?

Local Benefit (Required)

How does your organization benefit the local Mesa County Community?

About Your Organization (Required)

Briefly tell us the FIVE most important things you would like prospective volunteers to know about your organization or organizational culture

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Online Agency Application Form

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