Volunteer Form
Hello!

We appreciate your consideration to volunteer with us in order to address COVID-19 issues.

We will minimize your interaction with clients and others during your delivery and want to make sure that health precautions are taken.

If you have a cough, fever, sore throat and other symptoms of illness, please do not sign up at this time.

If you are over 65 or have chronic health concerns, please do not sign up.

If you live with someone who is in a higher risk category (over the age of 65 or are immunocompromised), please do not sign up.

Volunteers will also need a valid driver's license.

Please contact Lauren Marian at LMarian@LTSC.org if you have any questions or concerns.
Name and Pronouns *
Your answer
Email *
Your answer
Cell Phone Number *
Your answer
One need that many senior residents in our low income housing units have are personal hygiene products, including toilet paper and hand sanitizers. Do you happen to have any products available to donate? *
If you answered 'yes' to the previous question, what are you able to donate?
Your answer
What days are you available to volunteer? Please select ALL available days *
Required
What times of day work best for you? Please select ALL that apply! If the times differ per day, please make a not clarifying availability in the last section. *
Required
Where are you able to volunteer? Please select ALL that apply *
Required
Do you happen to speak another language? *
Required
How did you hear about this program?
Your answer
Additional questions / comments / concerns
Your answer
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