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IEA Volunteer Activity Submission Form
Please fill out the information below. Questions should be directed to Dorie Mayfield,
dlmayfie@gmail.com
.
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* Required
Email
*
Your email
Name
*
Your answer
Email Address
*
Your answer
Date of Volunteer Activity
*
MM
/
DD
/
YYYY
Number of Hours
*
Your answer
Person Who Managed or Coordinated Activity
*
Your answer
Transfer Hours?
Yes
No
Clear selection
Number of Hours to Transfer
Enter 0 if not transferring. Maximum of 5 hours.
0 hours
1 hour
2 hours
3 hours
4 hours
5 hours
Clear selection
Name of Rider to Receive Transferred Hours
Enter none if not transferring.
Your answer
Location & Brief Description of Volunteer Work
*
Your answer
A copy of your responses will be emailed to the address you provided.
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