Commonwealth of Virginia Campaign CVC EVENT REPORTING FORM
Hello CVC Coordinators! Please use this form after each CVC event you host. Please provide all necessary information below. Be prepared to upload CVC Event Tracking forms, paper pledges, and donation receipts. The CVC Team uses the information provided in this form to track agency campaign progression and reconcile transmittal reports received through the CVC Deposit Box. If you have any questions, please do not hesitate to reach out to the CVC Support Team at cvcsupport@dhrm.virginia.gov.
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| 1. |
Name of the CVC Coordinator completing this form:
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| 2. |
Work Email Address:
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| 3. |
Work Phone Number:
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| 4. |
State Agency Name:
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| 5. |
State Agency Code:
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Event Details
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| 6. |
Title of CVC Event:
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| 7. |
Date of Event:
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| 8. |
Brief description of the event:
| An answer is required | |
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| 9. |
Please list the information for each charity this event benefited. Provide all detail of donations for each charity and rather the donations were given directly to the charity or money needs to be sent to the CVC Processing Center.
Provide the information for charity in the following format: CVC Code - Charity Name: amount of donation. For example: "203040 - Virginia State Employee Assistance Fund: $200 being sent to the CVC Processing Center" "200138 - Feed More: $30 being sent to CVC Processing Center and 300 lbs of food given directly to charity"
| An answer is required | |
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| 10. |
How many employees donated during this event?
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| 11. |
Please upload your CVC Event Tracking Form showing the list of donors and how much each donated.
| CVC Event Tracking Form |
| Required |
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| 12. |
Of the following types of donations, which were collected during this event?
Select all that apply.
Please select {0} response(s)
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| 13. |
Please provide the totals collected during this event for each donation type below.
Please use zeros for any blank sections. |
| 14. |
Please upload ALL Paper Payroll Deduction Pledges:
| One file scan of all paper pledges |
| Required |
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| 15. |
Did you have any event-related costs? You must be able to provide receipts to cover all costs itemized.
Event costs can be costs associated with converting cash to money orders, small event prizes, etc. |
| 16. |
Please itemize all event costs being reported below.
Cash to Money Order exchange: $10.00 at First Citizens Bank Gift Basket for Prize Drawing: $25.00 at TJ Maxx
| An answer is required | |
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| 17. |
Please upload ONE file containing receipts showing event costs described above. Please circle line items on receipts related to event costs.
| Event Costs Receipts |
| Required |
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| 18. |
Were any of the donations above directly given to a charity? Items, food, and time volunteered donated to a charity are considered direct giving.
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| 19. |
Please upload a donation receipt from the charity verifying your direct giving.
| Direct Giving Donation Receipts |
| Required |
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| 20. |
Do you need to send money to the CVC Processing Center?
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| 21. |
Please detail below what is being sent to the CVC Processing Center.
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