2016 —17 Volunteer & Business Involvement Report
BASES
In order to recognize and honor businesses and other outside organizations for their contributions on a county-wide basis (BASES), please complete this form for businesses or organizations who have contributed either volunteer service, equipment or other items, or financial aid to your school this past school year. Please include only one business or organization for each form when there is a dollar amount. If used for volunteer hours for a business with multiple employees or members, then it can be combined in one entry, whatever is easiest.

Forms need to be completed by June 14. If you have any questions in regards to this form please contact Suzie Ulbrich at 989-2021 ext. 20302. Thank you for your assistance.

School *
First name of person submitting report *
Your answer
Last name of person submitting report *
Your answer
Business Name or Organization Name *
Your answer
Business Address or Organization Address *
Your answer
Contact for Business/Organization (full name) *
Your answer
Telephone Number of Business or Contact *
Your answer
Donation information or Service(s) Provided Information *
Your answer
Total Financial Value for Goods or Services (put 0 if you are going to add volunteer hours below) *
Your answer
Business/Organization Volunteer Hours (can be one person's total hours or total hours for several people from the same business or org.) *
Your answer
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