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Volunteer Application Form

First name

Last name

Phone

Cell phone

Allow text messages from Demo Village?

Date of birth

Marital status

Gender

Sexual orientation

Ethnicity

Number

Street

City

State

Zip Code

Areas of Interest for Volunteers

Computer Wiz PC

Dentist

Drive

Errands

Friendly Visit

Gardening

Grocery/Meal deliver

Handy Person

In Home Assistance

Organizing

Plumbing

Read aloud

Snow removal

Volunteer for Demo Village

Accounts payable

Administration

Answering Phones

Data Entry

Envelope Stuffing

Event Helpers

IT Technical

Phone Outreach

Provider Vetting

Service Requests

Special Gift Bag

Website maintenance

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?

Current Health

Mobility issues

Home type

Employment status

How did you hear about us

Do you hold an OLLI Membership? Yes

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!