|
U.S. Department of JusticeEmployee Volunteerism Informational Survey |
Name:
Agency:
Site/Location: Gender:
Title: Grade:
Type of Volunteer/Community Service:
| # of Programs, Groups, or Activities | Type/Category of Service | Est. Hours Per Month | ||
|---|---|---|---|---|
| Human Needs | ||||
| (Examples: health services, rebuilding neighborhoods, helping people who are homeless) | ||||
| ( ) | Public Safety | |||
| (Examples: homeland defense, neighborhood watches, victim/domestic violence services) | ||||
| ( ) | Pro Bono Legal | |||
| (Examples: legal work or bar clinics for the elderly, children, or homeless, will writing) | ||||
| ( ) | Environment | |||
| (Examples: restore neighborhood parks, conservation education, planting trees in your community) | ||||
| ( ) | Education | |||
| (Examples: day care volunteer, PTA member, ESL instructor, tutor, mentor) | ||||
| ( ) | Faith-Based Organizations | |||
| (Examples: volunteering and service to your community through a faith-based organization) | ||||
If you have provided pro bono legal assistance, please briefly describe the nature of your assistance:
Do you provide services as a part of a community service program (i.e., DOJ Partners in Education Programs, American Red Cross Blood Drives, etc.) sponsored by your component/agency:
Yes No