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) and Administrative volunteers only. All applicants should choose "individual" below the name fields. Spouses/partners who intend to serve together should complete their own individual application. Additionally, Neighborly's MOW program and its volunteer opportunities are Monday through Friday between 10:30am and 2:30pm.

Lastly, please note: we are currently recruiting for volunteers in Clearwater, Largo, Pinellas Park and South St. Pete only at this time.

Thank you again!

Contact Information

First name:

Last name:

Kind:

Individual Group

Group 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 AM and 2 PM.

Email Preferences

We like to keep volunteers informed of important news, trainings, and volunteer opportunities by email, however will not send you any email you prefer not to receive. Use the checkboxes below to select the kinds of email and texts you would like to receive from us.

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 and Dining Site volunteers.

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.

Times

Assignment

Wednesday July 15, 2020:

10:00am to 12:00pm

Orientation [Neighborly Care Network\ADMIN - Administration]

Wednesday July 22, 2020:

10:00am to 12:00pm

Orientation [Neighborly Care Network\ADMIN - Administration]

Thursday July 30, 2020:

1:00pm to 3:00pm

Orientation [Neighborly Care Network\ADMIN - Administration]

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: For those serving more than once

If you are an individual who will serve on a regular basis and are also 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 also agree to keep all information regarding clients confidential per HIPAA requirements.

I Agree