Volunteer Application - About Care, Inc

Date / Time *

Date

Time

Your name *

First

Last

Birthdate *

Fingerprint Card/ID Card #

Card Expiration Date

Email Address *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Cross Streets *

Home Phone *

Cell Phone *

Work Phone

Have you had the COVID19 Vaccination? *

Yes
No

Please check all that apply *

Education *

Major/Degree *

What are your hobbies and interests? *

Are you and/or a family member a Veteran? *

Yes
No

Who?

Are you bilingual? *

Yes
No

What languages do you speak? *

Place of Employment *

Occupation *

Resume/CV/Certificate – File Upload (Optional)

Click or drag files to this area to upload. You can upload up to 3 files.

Does your place of Employer have a Volunteer Match Program? *

Yes
No

Would your employer be interested in partnering with About Care to do a volunteer recruitment presentation? *

Yes
No

Please provide employer contact information, name, phone number and email address.

What support services would you like to provide About Care Clients? You may check more than one service. *

Business Help (Office Helper, Cell Phone Technical Support, IT Support)
Friendly Visits
Fundraising (Outreach Volunteer, Booth Events)
Minor Repairs (Household Tasks: Light Bulb Change, Air Filter Change, Yard Work)
Reassurance Calls (Wellness Check-up Calls, Friendly “Hello” Calls)
Respite
Shopping & Errands (Grocery Shopping Online, Picking Up Medications)
Transportation ( Grocery Store, Medical Appointments, To/From Work)
Other Services (Gift Delivery, Mailing Gift Cards)

Please provide a brief description of your "Other Services".

Volunteer Availability – Please check all that apply. *

Emergency Contact 1 *

Relationship to Volunteer

Emergency Contact 2 *

Relationship to Volunteer

Reference Contact 1 *

Reference Contact 2 *

How did you hear about our organization? Please check all that apply. *

Why do you want to Volunteer for About Care? *

I agree to allow About Care, Inc. to use my photograph while providing services for the organization. *

Yes
No

Photo Release – I agree to allow About Care, Inc. to use my photograph while providing services for the organization. I acknowledge these pictures may be used for the About Care Website, Social Media, Newsletter, and Marketing Materials. Typing your name into the text box will represent your electronic signature and will be date and time stamped when you submit this application.

Driver's License # *

Expiration Date *

Auto Insurance *

Policy # *

Expiration Date *

Comments