becoming a neighborly volunteer

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Becoming a Neighborly Volunteer

We have many people who volunteer to help their neighbor from time to time. But as our needs are growing there is always the need for more generous volunteers. There is no minimum requirement of time you must serve. You will be called on and then you decide on a case by case basis if you are available. We primarily ask our volunteers to serve literally in their own neighborhood, however, some volunteers are willing to travel up to 20 miles to help someone in need. You can state your preference for where and when you'd care to serve.

As you might expect, we do have a screening process starting with an application for all who will serve. We must become aware of your background and the best way for you to serve. Please fill out an application here, print out an application and mail it in, or contact us and ask for an application packet. Thank you for considering!

Click here to download and complete an application by hand

Or fill out the form below

Name

Birth Date

Home Phone

Work Phone

Cell Phone

E-Mail Address

Street Address

Mailing Address (if different)

A. What days of the week can you help?

Any

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

B. What time of the day can you help?

Anytime

Mornings

Afternoons

Evenings

Is there a time of the year when you are less likely to volunteer?

C. Which of the following activities can you help with?

Friendly Visiting Assist with Medicare, Tax,

Phone Contact Insurance, or Other Forms

Shopping or Errands Do Post-Hospitalization Follow-Up Visits

Give Rides Help with Blood Pressure or Blood

Light Housework & Laundry Glucose Screenings

Meal Preparation Help with Group Service Projects

Help with Personal Care or Hygiene Help Prepare for an Event like the

Lawn or Garden Care HealthFair or Health Screening

Snow Removal Give a Talk. Topic

Minor Home Repair (Ex. Home Safety or Nutrition)

Give Respite to Caregivers Help in the Office with Mailings

Other Household Chores like Mail or Projects

Pick-Up or Taking Out the Garbage Do Fund-Raising; Write Grants

Serve on the Board or a Committee

D. Please list your volunteer experiences

E. Please list job/careers you have had or currently have that have given you contacts or skills that are helpful in your volunteering

F. What hobbies or past-times do you have that you may be able to share with someone else?

G. Do you have any health challenge or disability that may limit your volunteering? If yes, please explain

H. Have you ever been convicted of any misdemeanor or felony?

Yes No

If yes, please explain

I. Have you been through any personal or family challenge yourself that you would be able to help someone else through. Examples may be a serious illness, losing a loved one, a divorce, drugs or suicide in the family, placing a family member in a nursing home, hospice care?

J. Are there any other ways you can help that have not been mentioned?

K. References- Please give the names of three people who have known you for at least a year.

Name Address Phone Number

Thank You

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