Submit a request

Use dashes: xxx-xxx-xxxx

Name of group or organization

Line 1: Street Address; Line 2: City, State, Zip *Must be in Scott or Rock Island County

For Supply Requests: Requests with less than a week's notice may not be possible due to the availability of supplies.

Number of Volunteers x Hours Worked (Ex: 50 x 3 hours = 150 hours)

Ex: tires, furniture, etc.

Please enter more details of your request. If none, enter "N/A". A member of our staff will respond as soon as possible.

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