Volunteer Application

Your Name (required)

Date

Address

Postal Code

Phone (Home):

Phone (Work):

Phone (Cell):

Your Email (required)

Length of service

Drivers License #

Insurance Co. & Policy #

Do you currently have a police check with vulnerable sector screening?
YesNo

Emergency Contact

Emergency Contact Telephone

(Relationship)

Where did you learn about Meals on Wheels

I would prefer to drive on a weekly route (if available)
YesNo

OR, I would like to be on the substitute driver list:
YesNo

I am available on

Are you interested in volunteering in other areas (office work, special events etc.) ?

References (excluding friends/relatives):

#1 Name

Telephone

Company/Title/Relationship

#2 Name

Telephone

Company/Title/Relationship