Group Volunteer Application Download PDF ApplicationToday's Date MM slash DD slash YYYY Organization Name* Contact Person* First Last Email* Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code PhoneOrganization Sponsor (optional) Sponsor PhoneSponsor Email Days Available* Select All Monday Tuesday Wednesday Thursday Friday Start Date* MM slash DD slash YYYY End Date (optional) MM slash DD slash YYYY How did you find out about Meals on Wheels? College Affiliation Longwood Hampden-Sydney None Other Interests Fundraising and Special Events Volunteer Recruitment Public Relations Serving on Board of Directors List two (2) references (separate with a comma): Consent 1) Meals on Wheels delivers meals to elderly, disabled & homebound adults in need of balanced, nutritious lunch time meals. 2) Meals on Wheels does not discriminate based on any particular illness, age, race, gender or religion. 3) Meals on Wheels respects and protects Client confidentiality and ensures Volunteer safety. I understand that I may deliver meals to Clients diagnosed with infectious diseases or to Clients who may be unaware that they have infectious diseases. I have read ALL statements and agree to represent Meals on Wheels as directed. To the best of my knowledge, all members of our organization who will serve as volunteers agree to the above statements and have not been convicted of either a felony or sex crime.* Yes No Signature* Date* MM slash DD slash YYYY
