IMD Guest House – Non-Profit Hospitality House for Cancer & Medical Patients Chicago

Project Inquiry Form

Project Inquiry Information

Company Name

Prefix

Contact First Name *

Contact Last Name *

Street

Street 2

City

State

Zip

Contact Email *

Please Note- Our communication is performed through email. If you prefer to be contacted by telephone, please let us know.

Cell Phone Number

Work or Home Phone Number

I prefer to be contacted by telephone

If you are a group, please indicate what best describes the group. Check all areas that apply.

Community Organization
Corporate
Non profit Organization
Faith Based Organization
Civic / Government
Academic Association- Honor Society, Etc.
Group connected with a hospital (Nurse/Doctor Association, Board, Etc.)
Education- College Level
Education- Grades PK-12
Club
Rotary

Other, please describe

How did you hear about IMD Guest House? Please check all that apply.

Volunteer Fair
VolunteerMatch.org
A Volunteer
IMD Guest House Staff or Administrative personnel
IMD Guest House Website
Internet
Other

Proposed Project Date

1st Preferred Volunteer Date *

2nd Preferred Volunteer Date

Donated Items for Project:

Additional Inquiry Information

Community Room Project Selection (All weekday projects must end by 8:00 p.m. and all Saturday projects must end by 2:00 p.m.)

Evening Meal Maker (Volunteers arrive by 5:00 p.m.)
Grab 'n Go Breakfast (Volunteers arrive by 8:00 a.m.)
Weekday Baker (9:00 a.m. - 8:00 p.m.)
Saturday Breakfast (Volunteers arrive by 8:00 a.m.)
Saturday Baker (Volunteers arrive by 10:00 a.m.)

Other Projects:

Guest Greeter
Welcome Baskets
Comfort Cards
Administrative / Clerical
Special Events

Other- (Please describe)

Completing Volunteer Hours as a Requirement?

Require verification of volunteer hours? *

Yes
No

If yes, how many hours?

Due date for requirement of volunteer hours

// (MM/dd/yyyy)

Complete Inquiry

Questions or for more information about volunteer opportunities, please contact the Volunteer Coordinator at 312-996-9287

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