The FriendShip -- Volunteer Application
First Name *
Middle Name or Initial
Last Name *
Preferred Name
Birthdate *
MM
/
DD
/
YYYY
Address 1 *
(be sure to include apartment number/letter somewhere, if applicable)
Street Address 2
(if applicable)
City *
State *
Zip Code *
(5 digits)
Home Phone
example: 803-602-6434
Cell Phone
example: 803-602-6434
Work Phone
example: 803-602-6434
Email Address
Ways you would like to help members of The FriendShip
Technology Assistance
Select all that apply.
Emotional Support
Select all that apply.
Appointment Support
Select all that apply.
Household Business Assistance
Select all that apply.
Minor Household Maintenance
Select all that apply.
Home Repair
Select all that apply.
Errand Running
Select all that apply.
Transporting Members to
Select all that apply.
Temporary Basis
Select all that apply.
Driver Options
Select all that apply.
Assist The FriendShip with
Select all that apply.
Please add any areas of interest not listed.
Tobacco Sensitivities: Are you comfortable serving those who use tobacco products?
Select one.
Clear selection
Tobacco Use: Do you or a member of your home use tobacco products?
We need this information for matching volunteers to members who are very sensitive to tobacco products and residue.
Clear selection
Availability: The FriendShip recognizes and understands the need for flexibility.
Select the days and times of day you might like to be available to serve members. Note that an assignment could take from 15 minutes to 3-4 hrs, but not the entire time period..... (Morning 8am - 1pm).....(Afternoon 12pm - 5pm).....(Evening 5pm - until)
Monday
Select all that apply.
Tuesday
Select all that apply.
Wednesday
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Thursday
Select all that apply.
Friday
Select all that apply.
Saturday
Select all that apply.
Sunday
Select all that apply.
Frequency of Assistance: Weekly or Monthly
Select one.
Clear selection
Personal and/or Work Reference (1st) *
Include Full Name - Title/Relationship - Phone - Email
Personal and/or Work Reference (2nd) *
Include Full Name - Title/Relationship - Phone - Email
Person to Notify in Case of Emergency:
Full Name - Relationship - Address - Home Phone - Work Phone - Cell Phone - Email
Please verify that you understand that. . . *
Volunteers that are accepted for participation with The FriendShip will be asked to authorize a background check. Drivers will be asked to provide information relating to a driver’s license and auto insurance.
Comments or questions:
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