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Volunteer Application Form

Helping Older Adults Live Independently
Phone: 302-500-1281

Please note in the additional comments below if you have any relevant expertise not listed here.

First name

Last name

Phone

Cell phone

Date of birth

Gender

Number

Street

City

State

Zip Code

Areas of Interest for Volunteers

Computer Wiz-MAC

Computer Wiz-PC

Friendly Visit

Gardening

Grocery/Meal deliver

Handy Person

Organizing

Pet Care

Transportation

Trips to Friends

Volunteer for South Coastal Village Volunteers

Accounts payable

Administration

Answering Phones

Data Entry

Envelope Stuffing

IT Technical

Office Support

Phone Outreach

Provider Vetting

Service Requests

First reference name

First reference email

First reference cell phone

First reference phone

First reference relationship

Second reference name

Second reference email

Second reference cell phone

Second reference phone

Second reference relationship

Previous Volunteer Experience?

Do you have current and valid drivers licence?

Do you have current and valid car insurance?

How did you hear about us

Additional Comments

I confirm that I have read, consent and agree to Revolutionaging’s (Helpful Village’s) TERMS OF USE and PRIVACY POLICY

Thank you for your interest

Thank you for your interest and we will be in touch with you very soon!