ADULT Volunteer Application Form

First name

Last name

Phone

Cell phone

Date of birth

Gender

Number

Street

City

State

Zip Code

Areas of Interest for Volunteers

Assisting with planting flowers & light gardening (not a replacement for regular landscaping/yard maintenance)

Friendly Visits

Help with paperwork (sorting mail, organizations/sorting etc.)

Light moving assistance (sorting mail, organizations/sorting etc.)

Organizing

Pet Care (Short term assistance with walking, feeding, etc.)

Phone Connections (Check in calls)

Racking leaves or clearing branches after a storm

Simple home Maintenance (Changing light bulbs/furnaces filters, etc. )

Snow Removal/Snow Angels (Snow removal limited to 50' in length)

Social Event Support

Special Interests

Technology support

Transportation - Dr Appointments

Transportation - Errands, grocery store, with patron

First reference name

First reference email

First reference cell phone

First reference phone

First reference relationship

Previous Volunteer Experience?

Do you have current and valid drivers license?

Do you have current and valid car insurance?

Current Health

Mobility issues

Home type

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 contacting us — it’s a pleasure to connect! Our team is committed to providing friendly, professional assistance, and we’ll be reviewing your message right away. You’ll hear back from us soon.