2015 Luke's House Volunteer Hours

Help us track our volunteer hours more accurately by completing this form. Individual volunteer reports will be distributed at the end of each fiscal year. Contact director@lukeshouseclinic.org if you have questions.

What is your name?

First and Last. No abbreviations.

This is a required question

Event Type

This is a required question

On what date did you volunteer?

MM/DD/YYYY

What is your e-mail address?

This is a required question

How many hours did you volunteer?

Numeric to one decimal place, e.g. 1.5

This is a required question

What is your designation?

This is a required question

May we add your e-mail address to our distribution list?

This is a required question