Neighborly Care Network’s Volunteer Application Form

Thank you for your interest in volunteer opportunities at Neighborly Care Network! Please complete this application form to be considered. Our minimum age to volunteer is 18. Once you complete the form, please click the I AGREE button at the bottom.

SPECIAL NOTES: During the Coronavirus pandemic, Neighborly will be accepting applications for Meals on Wheels (MOW), Veterans Meals on Wheels, and Bags on Wheels volunteers only. Spouses/partners or members of a group/employer who intend to serve together on an ongoing basis should complete their own individual application. Additionally, Neighborly's MOW program and its volunteer opportunities are Monday through Friday generally between 10:30am and 2:30pm.

Please note: we are limiting attendance at our orientations for health and safety reasons so they do fill up quickly. We will be adding more orientations when possible.

Thank you for choosing to share your time and talents with us!

Contact Information

First name:

Last name:

Street 1:

Street 2:

City:

State:

* Zip: *

Home phone:

OK to call me here

Cell phone:

* OK to call me here

Email address:

Demographic Information

Please provide the following demographic information used only for funding agency requirements.

Date of birth:

Age:

Gender:

Ethnicity:

Availability

Please indicate the days and times you are usually available to volunteer. Generally, volunteers serve between 10:30 AM and 2:30 PM.

Email

Email is the only way our small staff are able to effectively and efficiently keep our volunteers informed of important policy and procedure updates as required by our funders, therefore our ability to communicate with you via email is required.

Assignment Preference

Please select the role or roles that interest you. You can click on each to see its location and description. Choose from Meals on Wheels (MOW) driver, Dining Site, Adult Day Center client assistance, Adult Day Center entertainer, Pantry, Board of Directors, and administrative (clerical) options. **At present, Neighborly is only actively recruiting Meals on Wheels volunteer drivers, Veteran's Program and Bags on Wheels grocery delivery.

Orientation

Attendance at orientation is required prior to service. Please select which orientation session you will attend below and be sure to add it to your personal calendar! Orientations are held at our Administration office located at 13945 Evergreen Ave., Clearwater, FL 33762 unless otherwise noted (Sunshine Center Auditorium, 330 5th St N in St Pete is the location for orientation on 12/2)!

Emergency Contact

In the event of an emergency, whom should we notify?

First name:

Last name:

Home phone:

* OK to call here

Cell phone:

* OK to call here

Relationship:

How did you hear about us?

How did you hear about us?:

Please let us know if you have any limitations.

Group name (if applicable):

If you are an individual who will serve as part of a group/employer/church, etc. please list the group here.

I AGREE

I understand and agree that submitting this application does not automatically register me as a Neighborly Care Network volunteer, and that there may be certain qualifications I must meet, including orientation, training, a background check, and the acceptance of established policies and procedures, before I may begin volunteering. By submitting this form I attest that I am at least 18 years old, and the information I have provided on this form is true and accurate. I understand if the information submitted is not accurate, I may be dismissed from volunteer service. I acknowledge that Neighborly Care Network does not accept court-ordered community service volunteers. I agree to keep all information regarding clients confidential per HIPAA requirements.

I Agree