Businesses and Organizations - Volunteers for Prosperity

Part 1. About Your Business or Organization

Please complete the following information on your business or organization.

Business/Organization - General
Business/Organization Name
Primary Contact Name
Primary Contact Number

Address
Street
City		State
Country		Zip Code
Phone		Fax
Email		URL

Overview

Business or Organization Overview
(Enter a one to three paragraph summary about your business or organization and its capabilities.)

Summary of Business or Organization's International Voluntary Service Activities
(Enter a one to three paragraph summary about the business or organization's recent, current and future international voluntary service activities. Include the number of volunteers deployed during the past twelve months, the number of volunteers to be deployed over the next twelve months as well as a current estimate of the number of prospective volunteers accessible to the business or organization.)

Part 2. Volunteers for Prosperity Opportunities

Please complete the following regarding international voluntary service opportunities available through your business or organization.

Regions and Categories

How many opportunities are available?

To what geographic regions do these opportunities apply? (check all that apply)

Africa	Asia	Caribbean	Central Europe
Latin America	Middle East	Near East	Russia
Fr. Soviet Union	Other

Please list the countries that you like to have listed with your organization on the VfP Global Map.

To what "health and prosperity" sectors do these opportunities apply? (check all that apply)

Agriculture	Economic Growth	Health	Reform
Capacity Building	Education	HIV/AIDS	Water
Competitiveness	Information & Communication Technology	Natural Resources Management	Women & Youth Empowerment
Tsunami Relief /Reconstruction	Malaria

Please indicate the number of volunteers deployed to each sector:

Agriculture	Economic Growth	Health	Reform
Capacity Building	Education	HIV/AIDS	Water
Competitiveness	Information & Communication Technology	Natural Resources Management	Women & Youth Empowerment
Tsunami Relief /Reconstruction	Malaria

What types of opportunities are available? (check all that apply)

Management

Technical

Support

Other

Volunteer Profile Summary
Please summarize your business or organization's representative international voluntary service opportunity:
Average Project Duration (in days/weeks/years)
Volunteer Profile (Enter a one to three paragraph description of your representative volunteer. Include information about professional background, skills, and capabilities.)

Please describe plans or current activities for utilizing American professionals in volunteer relief efforts in the areas affected by the tsunami.

Part 3. Volunteer Recognition

Your business or organization can recognize the contributions of your volunteers through the President's Volunteer Service Award program.

Is your business or organization a "certifying organization"? go to link above for eligibility criteria.	Yes No
If "yes", how many volunteers have been recognized during the past 12 months?
How many volunteers will be recognized during the next 12 months?
If "no", is your business or organization interested in learning more about the program and the steps necessary to becoming a "certifying organization"?	Yes No