1. * Organization Name
2. Description
3. * Address Line One
4. Address Line Two
5. * City
6. State Other AL - Alabama AK - Alaska AZ - Arizona AR - Arkansas CA - California CO - Colorado CT - Connecticut DE - Delaware DC - District of Columbia FL - Florida GA - Georgia GU - Guam HI - Hawaii ID - Idaho IL - Illinois IN - Indiana IA - Iowa KS - Kansas KY - Kentucky LA - Louisiana ME - Maine MD - Maryland MA - Massachusetts MI - Michigan MN - Minnesota MS - Mississippi MO - Missouri MT - Montana NE - Nebraska NV - Nevada NH - New Hampshire NJ - New Jersey NM - New Mexico NY - New York NC - North Carolina ND - North Dakota OH - Ohio OK - Oklahoma OR - Oregon PA - Pennsylvania PR - Puerto Rico RI - Rhode Island SC - South Carolina SD - South Dakota TN - Tennessee TX - Texas UT - Utah VT - Vermont VI - Virgin Islands VA - Virginia WA - Washington WV - West Virginia WI - Wisconsin WY - Wyoming AB - Alberta BC - British Columbia MB - Manitoba NB - New Brunswick NL - Newfoundland and Labrador NT - Northwest Territories NS - Nova Scotia NU - Nunavut ON - Ontario PE - Prince Edward Island QC - Quebec SK - Saskatchewan YT - Yukon Territory
7. * Zip Code
8. Organization Phone Number
9. Fax Number
10. TTY Number
11. Organization Web Site

1. Volunteer contact
2. First Name
3. Last Name
4. Email

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6. Person filling out form
7. * First Name
8. * Last Name
9. * Office Phone
10. * Office Email
11. * Verification
    Please complete the verification task.

Choose the location of the volunteer opportunities for this organization. You may choose either Nationwide, a single state for state-wide opportunities, or specific counties by clicking on the List Counties button after selecting a state.

1. States Served Nationwide New JerseyAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming
2. Counties Served
   Statewide EssexAtlanticBergenBurlingtonCamdenCape MayCumberlandGloucesterHudsonHunterdonMercerMiddlesexMonmouthMorrisOceanPassaicSalemSomersetSussexUnionWarren
   Hold down the control (Ctrl) key while clicking
   to select more than one choice.

1. Hours for Pro Bono opportunities EveningsFlexibleMonday-Friday 9am-5pmWeekends
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   to select more than one choice.
2. Other hours
3. Income Ceiling
   The income ceiling poverty level should be between 100-300
4. Income Floor
   The income floor poverty level should be between 0-300