Volunteer Application Form

First name

Last name

Phone

Cell phone

Date of birth

Marital status

Number

Street

City

State

Zip Code

Areas of Interest for Volunteers

Home Office Assistance - Assist with on-line grocery order

Home Office Assistance - Assist with online bill pay

Home Office Assistance - Computer (laptop, PC, phone) help

Home Office Assistance - Read emails out loud

Minor Home Assistance - Change batteries in smoke detector

Minor Home Assistance - Cold weather yard assist (cover trees, hose disconnect)

Minor Home Assistance - Time change (clocks including irrigation)

Minor Home Assistance - Trash cans to / from the curb

Minor Home Maintenance - Computer help other (router, printer setup)

Minor Home Maintenance - Help with holiday decorating

Minor Home Maintenance - Organizing / closet cleaning

Transportation Assist - Pick-up groceries for on-line order

Transportation Assist - Pick-up prescriptions

Transportation Assist - Ride to doctor appointment in Leland

Transportation Assist - Ride to doctor appointment in Wilmington

Visitation - Phone buddy

Visitation - Play a game / work on puzzle

Visitation - Porch visit

Visitation - Read a book / magazine

Visitation - Wellness call / visit

Visitation - meal assist (warm up prepared meal, set table, clean-up) - no prep/cooking

Volunteer for Compass Pointe Village

Accounts payable

Administration

Answering Phones

Data Entry

Envelope Stuffing

IT Technical

Phone Outreach

Provider Vetting

Service Requests

First reference name

First reference email

First reference cell phone

First reference phone

First reference relationship

Do you have current and valid drivers licence?

Current Health

Mobility issues

Employment status

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!