Detroit Area Agency on Aging | Volunteer Questionnaire
This interest form is intended to allow us to send you information relevant to your interests as well as match you with appropriate volunteer opportunities as they become available.

Please fill this form out in its entirety.  If there are others in your household who are 15 years old or older and interested in volunteering please have them complete the form individually.

Completing this form should not take longer than 10 minutes.

Thank you so much for your support and participation!
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First and Last Name *
Address *
Apt./Suite
If applicable
City *
State *
Zip Code *
Home Phone Number *
Cell Phone Number *
Email Address *
What month and day were you born? *
MM
/
DD
Gender *
Please enter your preferred gender identification
Please briefly describe your volunteer & work experience *
(e.g. organziations you've previously volunteered/worked with, key responsibilities you've held, etc.)
Emergency Contact Name & Relation *
Emergency Contact Phone Number *
What kind of personal vehicle do you have available for use? *
Check all that apply and you are willing to use for service
Required
Current Employment Status *
Please select the option that best describes your CURRENT employment status
Current Student Status *
Please select the option that best describes your CURRENT student status
Are you interested in volunteering for
Clear selection
Have you volunteered with us before? *
If yes, what month and year and what activity did you do (e.g. hot pack, deliver)? If "No" type N/A *
What kinds of skills do you have *
please check all that apply
Required
What Kinds of Volunteering are You Interested In? *
Check all that apply
Required
How Frequently Are you Available *
Check all that apply
What Days of the Week are Best for you *
Check all that apply, we will ask about times of day next.
Required
On days when you have limited availability, which times were best for you? *
Check all that apply
Required
Have you had a background check in the last 5 years? *
Some of our volunteer activities require that you have a background check. If you have had one in the last 5 years you may submit it to us.
Are you willing to submit a background check to us as needed? *
Some of our volunteer activities require that you have a background check. If you have not had one, we will run it for you at no cost.
Do you need court mandated community service hours? *
Do you need community service hours for school? *
Do you work with any organizations that may want large groups to volunteer (e.g. AARP chapter, sorority/fraternity, your job, etc.)?
If yes, please list them.
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