Volunteer Sign-up

Please complete the form below. An Interfaith Caregivers representative will contact you shortly. After submission of this form, you will also be asked to complete the Interfaith Caregivers Pledge and Reference forms.

Complete Form to Volunteer

First name

Last name

Mobile Phone

Home Phone

Street Address

Street Address Line 2

City

Region/State/Province

Postal / Zip code

Country

How did you find out about us?

COVID-19: We recommend that all seniors using our services be vaccinated for Covid-19. Have you received or are you scheduled to receive them? Please list the dates of all Covid-19 vaccinations below.

Are there any physical considerations, such as allergies, mobility, or lifting issues that could affect which assignment you can take?

Which days are you available?

Mon

Tue

Wed

Thu

Fri

Sat

What time are you generally available?

Morning

Afternoon

Evening

What are your interests as a volunteer?

Companionship (visiting a client)

Respite Care (visiting a client so caregiver gets a break)

Telephone Reassurance

Provide a meal on an occassional basis

Grocery shop for someone

Transportation (appointments, errands, etc.)

Volunteer in Office

Serve on a Committee

Driver's License Number

License Exp. Date

What type of vehicle do you drive?

Sedan, 2-door

Sedan, 4-door

Crossover, small SUV

Large SUV

Minivan

Emergency Contact Name

Emergency Contact Relationship

Emergency Contact Phone

When Interfaith Caregivers applies for grants we are asked to provide general information on the racial backgrounds of clients and volunteers. To facilitate getting this financial support please check as many as you feel apply to you.

American Indian or Alaskan Native

Asian

Black or African American

Hispanic

Native Hawaiian/Other Pacific Islander

White

Other

Thanks for applying to volunteer with us! We'll get back to you soon.