Please note: fields in red are required information.

Organization Contact Information

First name:

Last name:

Title:

Address:

City / Town:

State:

Zip Code:

Country:

Day phone:

Email:

Organizational Profile

Legal Name:

Tax ID / EIN#

Doing Business As:

Chapter:

Address:

City / Town:

State:

Zip Code:

Province:

Country:

Director’s Name:

Director’s Day Phone:

Email:

Organization’s Mission Statement:

Invitation

Application Date:

Project / Event Title:

Sources of Funding: (What sources of funding have you secured for this project?)

History of Service: (Have you organized volunteer events in the past?  If yes, please describe.)

Estimated # of Total Volunteers: (Please indicate the total number of volunteers required.  Preferred minimum is 50 volunteers working for 6 hours)

Specific Tasks: (Please list specific tasks proposed for volunteers.  Be sure to note how many volunteers are required for each task)

Which elements of our GREEN service standard are addressed by this project? (Not every project will address every category; feel free to leave some questions unanswered.)

G: Grassroots generated projects: Explain how this project is community-generated and supported.

R: Reduce, reuse, recycle: Are there opportunities for us to use recycled or repurposed materials in any construction and/or to recycle any waste from the service day?  Please describe.

E: Engagement: How will you engage relevant community stakeholders to support and sustain this project?

E: Education: What opportunities are there to educate and engage the local community to ensure the project’s sustainability?

N: In what ways will this project support Timberland’s goal of reducing its corporate carbon emissions?

Impact achieved: (Please state the measurable objectives of your project proposal and how they contribute to Timberland’s GREEN service criteria.)

Sustainability: (How will the proposed service be sustained / cared for after the project is completed?)

Photos: (Please provide photos of the work to be completed)

Please complete and submit this form via email to Brianne Wood: bwood@timberland.com.  Thank you!