6 Sc Station Roster

Senior Corps Grant Application

NEW 2013 Senior Corps Station Roster FINAL.xls

OMB: 3045-0035

Document [xlsx]
Download: xlsx | pdf

Overview

Instructions
Stations
Station Types


Sheet 1: Instructions



Sheet 2: Stations

Project Information Station Information: All fields are required















Date of completion of the list Today's Date:
Name of the organization where the assignment is performed Volunteer Station Name Volunteer Station Supervisor First Name Volunteer Station Supervisor Last Name Mailing Address Line 1: If necessary Mailing Address Line 2: City State Zip Code (5-digit) Zip Plus 4 Area Code and Phone Number (123-456-7890) If a station supervisor does not have an email address, enter "none". Email Address # of Unduplicated Vols Please enter a single number. If the number varies, please give an average estimate. If volunteers from one station also work at another station, include them in the counts for both stations # Volunteers See worksheet for a list. Station Type (Hospital, School, govt, …) Veterans (Y/N) Focus Areas and Objectives Focus Areas and Objectives Focus Areas and Objectives Focus Areas and Objectives Focus Areas and Objectives Focus Areas and Objectives Focus Areas and Objectives Focus Areas and Objectives Focus Areas and Objectives Focus Areas and Objectives Focus Areas and Objectives Focus Areas and Objectives Focus Areas and Objectives Focus Areas and Objectives Focus Areas and Objectives Focus Areas and Objectives
Application/Grant #:































Sponsor:































Please use a descriptive title (not just "RSVP"). The title should be identical to the Project Title entered in eGrants. Project Title:































Project Director First Name:































Project Director Last Name:































Project Director Mailing Address Line 1:































If necessary Mailing Address Line 2:































City:































State:































Zip:































Area Code and Phone Number































Project Director Email





























































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































Sheet 3: Station Types


Volunteer Station Types

Adult Correctional Agencies
Adult Day Care
All Others (specify)
Animal Welfare Programs
Area Agencies on Aging
Before and After School Care
Chambers of Commerce
Clinics (non-residential)
Community Development Non-Profits
Community-Based Environmental
Congregate Meals/Meals on Wheels
Courts
Day Care
Day Dare (Pre-elementary)
Developmental Disability Agencies (non-residential)
Food Banks/Gleaning Programs
Head Start
Home Health Agencies (public and private non-profit)
Hospices
Hospitals/Medical Centers
Juvenile Correctional Facilities
Libraries
Mental Health Programs (non-residential)
Multi-Purpose Centers (Including Senior Centers)
Multi-Purpose/Senior Centers
Museums
Native American Schools
Non-Head Start Pre-Schools (education focused)
Nursing homes/Convalescent Centers/Hospices
Other Community and Economic Development (specify)
Other Educational (specify)
Other Environmental (Specify)
Other Health Care Organizations (specify)
Other Public Safety (specify)
Other Social Service Agencies
Parks/Recreational Agencies
Police/Law Enforcement Agencies
Post-Secondary Institutions
Private School
Public Housing
Public School
Public/Congregate Housing
Public/Private Elementary Schools
Public/Private Secondary Schools
Rehabilitation Centers (excluding sheltered workshops)
Residential Long-Term Care Programs
Service Organizations (Lions, Elks, etc.)
Sheltered Workshops/Centers (vocationally focused)
Teen Pregnancy/Teen Parenting Programs
Thrift Shops/Coops
Total number of faith-based Stations / Volunteers
Transitional Shelters/Centers (e.g. homeless, abused, other short-term
Umbrella Environmental Orgs (EASI, Wildlife Society)
Veterans Hospital
Vocational Centers
File Typeapplication/vnd.ms-excel
File TitleStation Roster
AuthorKerrane, Caitlin M. (Guest)
Last Modified ByRoberts, Angela
File Modified2012-09-05
File Created2004-12-03

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