Please provide the following information for our files and so that we may distribute a media release about your volunteer service with United Way of Southeastern Connecticut. Click on the submit button at the bottom when complete. Thank you! Name * Home Address * Email * Insert your preferred email address where we can reach you. Company/Organization * Company Address * Title * Professional and/or Educational Background Memberships Include any memberships in other business, professional, or volunteer organizations and list dates and offices held, if applicable. Awards or Honors Received Family Information Name of spouse, names and ages of children. Quote Please provide a quote about your experience with United Way, why you volunteers and support United Way, and/or how you Live United. CAPTCHAThis question is for testing whether you are a human visitor and to prevent automated spam submissions.