Husky Helpers: Agency Sign Up Form

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Agency Event Submission Form

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*Event Name:

*Agency Name:

*Contact First Name:

*Street Address:

*City:

*Contact Last Name:

*State:

*Zip:

*Contact Phone:

*Volunteers Needed:

*Length of Service (hours):

*Contact E-mail Address:

*Start Date:

*End Date:

*Description of Event:

*Event Category: Annual Events Animals Family Services Healthcare Mentoring Senior Citizens Youth Environment Other