Donated Services Form

Thank you for donating your time to the National Federation of the Blind.

Please use this form to enter your hours every month. If you have any questions please contact [email protected] or call Belinda Hooks at 410-659-9314, extension 2508.

Note: All fields with an asterisk (*) are required.

First Name: *

Last Name: *

State: - Optional

Email: *

2026 Month of Activity *

Hours Worked: *

Would you like to add hours for another month? - Optional

How many months would you like to add? - Optional

Second Entry

Month of Activity - Optional

Hours Worked - Optional

Third Entry

Month of Activity - Optional

Hours Worked - Optional

Fourth Entry

Month of Activity - Optional

Hours Worked - Optional

Fifth Entry

Month of Activity - Optional

Hours Worked - Optional

Sixth Entry

Month of Activity - Optional

Hours Worked - Optional

Seventh Entry

Month of Activity - Optional

Hours Worked - Optional

Eighth Entry

Month of Activity - Optional

Hours Worked - Optional

Ninth Entry

Month of Activity - Optional

Hours Worked - Optional

Tenth Entry

Month of Activity - Optional

Hours Worked - Optional

Eleventh Entry

Month of Activity - Optional

Hours Worked - Optional

Twelfth Entry

Month of Activity - Optional

Hours Worked - Optional

Additional Questions and Submit

Our donated services calculations are impacted by your employment status. Are you employed full-time? *

Certification: *

Second Entry

Third Entry

Fourth Entry

Fifth Entry

Sixth Entry

Seventh Entry

Eighth Entry

Ninth Entry

Tenth Entry

Eleventh Entry

Twelfth Entry

Additional Questions and Submit

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