Volunteer Application Download PDF Application Note: If you are an organization with multiple volunteers please fill out the Group Volunteer Application.Today's Date MM slash DD slash YYYY Name* First Last Date of Birth MM slash DD slash YYYY Email* Phone*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 Days Available* Select All Monday Tuesday Wednesday Thursday Friday I would like to be a:* Regular Driver (same route, same day, each week) Substitute Driver (on call, as needed) How did you find out about Meals on Wheels? Employment Club/Organization Affiliations Other Interests Fundraising and Special Events Volunteer Recruitment Public Relations Serving on Board of Directors List two (2) references (separate with a comma): Consent1) Have you been, or do you stand to be, convicted of either a felony or a sex crime?* No Yes 2) Meals on Wheels delivers meals to elderly, disabled & homebound adults in need of balanced, nutritious lunch time meals. 3) Meals on Wheels does not discriminate based on any particular illness, age, race, gender or religion. 4) 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. Signature* Date* MM slash DD slash YYYY
