Intel Retiree - Benefits - Volunteer Matching Grants Program Form


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Volunteer Matching Grants Program Form

Volunteer Matching Grants Program
Form to report school volunteer hours

Submit all volunteer hours by June 30th of each year.

* = Required field

Intel Retiree Employee Information
(Spouses are not eligible for this program)

Legal Name *
WWID *
Address *
City *
State/Country *		Zip *
Email address: * (if applicable)

Organization / School Information

Organization / School Name *

Principal / Contact

Address *

City *

State/Country *
Zip *

Volunteer activities

Start Date
MM/DD/YY End Date
MM/DD/YY Event / Type of volunteer activity Number of
Hours

*

*

*

*

I certify that at the time of the volunteer activity, I qualified as an eligible retiree of Intel Corporation. I further certify that these volunteer hours are my personal contribution and that neither I nor any member of my family received or will accept a benefit in return for or as a results of these volunteer hours.

I certify that the volunteer hours were used in accordance with the program's guidelines.