Jersey Cares | Corporate Service Inquiry Form

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Fields marked with an asterisk (*) are required.

Thank you for your interest in the Jersey Cares Corporate Service Program. Please complete this inquiry form and we will be in touch with you shortly.

If you have questions about this form, please contact Evan Lewis at evan@jerseycares.org or call our office at (973) 533-1993.

Contact Information

Salutation

First Name

The "first name" of the person we will call back regarding this inquiry.

Last Name

The "last name" of the person we will call back regarding this inquiry.

Company Name

Please enter the full name of your business and do not abbreviate.

Business Phone

Ex. (973) 555-5555. This is the number where we will call you back regarding your inquiry.

Email Address

The email address of the person making the inquiry.

Street Address

Number and street only in this field.

City

State

Only the two character abbreviation please. i.e, NJ, NY, CT, RI, etc.

Zip Code

County

If you are in the state of New Jersey please select the county.

Project Information

Date/Time

Please provide your ideal project date. We understand this may change.

How many volunteers are in your group?

A projected numerical number is sufficient.

What type of project are you interested in?

In Person Volunteerism

Virtual or Remote Volunteerism

Custom Collection Drives

Skills Based Volunteerism

Healthy Food Delivery Program

Senior Shoppers Program

Other Opportunities

This field is required

What community are you interested in serving?

You can list a city, county, region or state.

Are you working with a budget?

What else would you like us to know?

In 500 characters or less.

Additional Information

How did you hear about us?

Please check this box if you would like to "Opt Out" of the monthly Jersey Cares newsletter.

This field is required

Leave blank if you would like to receive the monthly newsletter.

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