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Volunteer Application Form
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Area of Interest for Volunteers
Computer Wiz-MAC
Computer Wiz-PC
Drive
Friendly Visit
Gardening
Grocery/Meal deliver
Handy Person
MedPal
Organizing
Pet Care
Trips to Friends
Volunteer for KCN Seniors CO-OP
Accounts payable
Administration
Answering Phones
Data Entry
Envelope Stuffing
IT Technical
Koffee Klatsch
Phone Outreach
Provider Vetting
Seniors's Centre Without Walls
Service Requests
First Reference Name
First Reference Email
First Reference Phone
First Reference Relationship
Second Reference Name
Second Reference Email
Second Reference Relationship
Second Reference Phone
Previous Volunteer Experience?
Do you have a Driver's Licence?
Do you have Current and Valid Car Insurance?
Mobility Issues
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No mobility issues
Walk with cane
Walk with walker
Use a wheelchair
Uses service animal
Need assistance getting in
and out of cars
Difficulty with Stairs
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Additional Comments
I CONFIRM THAT I HAVE READ, CONSENT AND AGREE TO REVOLUTIONAGING’S (HELPFUL VILLAGE’S) TERMS OF USE AND PRIVACY POLICY
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