Building a community for all ages

TimeBank Application Form for Organizations and Schools

Organization Information

Name of Organization/Business/School:*

Street Address, City, State, Zip:*

Contact Person:*

Job Title:*

Best Contact Number:*

Email Address:*

Hours of Operation:

Number of Active Volunteers:*

Please tell us about your organization and what you do. This information is helpful for us to evaluate appropriate matches or exchanges.

3. How Comfortable are members of your organization using any online meeting software (e.g.:Zoom, Microsoft Teams, Google Meet, etc.) to participate in a virtual meeting?

Very comfortable. We use online software to participate in virtual meetings all the time.Somewhat comfortable. We use online software to participate in virtual meetings a couple of times, but we are still not very familar with it.Somewhat uncomfortable. We have never used any online software to participate in virtual meetings, but we are eager to learn how to do it.Very Uncomfortable. We have never used any online software to participate in virtual meetings and we are not willing to learn how to use it.

Service Checklist (Check off all that apply)

Services	We can Offer	We would like to Receive
Technology
“How to operate a tablet/ a cell phone/ Zoom” webinar	I can OfferI would like to Receive
	I can OfferI would like to Receive
Health and Wellness
Virtual stretching/ Tai Chi/ yoga/ meditation classes	I can OfferI would like to Receive
	I can OfferI would like to Receive
Hobbies
Virtual knitting/ crafting/ painting classes	I can OfferI would like to Receive
Virtual baking/cooking classes	I can OfferI would like to Receive
Participate in virtual live music event hosted by Senior Center	I can OfferI would like to Receive
Virtual game/ book club (facilitator sharing their screen)	I can OfferI would like to Receive
	I can OfferI would like to Receive
Housing Assistance
Provide suggestions on basic home repair solutions	I can OfferI would like to Receive
Help with connecting to a trustworthy handyman via telephone, text, or online	I can OfferI would like to Receive
Provide support on yard work, gardening, or basic snow removal	I can OfferI would like to Receive
	I can OfferI would like to Receive
Community Assistance
Admin support for Age-Friendly Glen Cove (e.g.: attending virtual community meetings, creating surveys and lists)	I can OfferI would like to Receive
Admin support for timebanking	I can OfferI would like to Receive
Admin support for other organizations	I can OfferI would like to Receive
	I can OfferI would like to Receive
Teaching
Tutoring/mentoring (e.g.: teaching language, finance, art…):	I can OfferI would like to Receive
Test prep: (circle subjects) GRECitizenGED	I can OfferI would like to Receive
	I can OfferI would like to Receive
Other (additional services not included above)
	I can OfferI would like to Receive