MEALS ON WHEELS OF MERCER COUNTY VOLUNTEER APPLICATION
PLEASE COMPLETE FORM AND SUBMIT:
Email address *
Name *
Your answer
Date of Birth *
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Full Mailing Address *
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Home Phone Number *
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Cell Phone Number *
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Email Address *
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How do you prefer to be contacted? *
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Please Enter Emergency Contact information with Phone numbers and Relationship: *
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How did you learn about Meals on Wheels of Mercer County (MOWMC)? *
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Educational Background *
Required
Major Field of Study? *
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Church/Civic/School affiliations: (optional)
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Name of Current Employer *
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Location (City/State) *
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Employer Phone *
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Position Held
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Work Phone
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May we call you at work? *
List 2 Previous Volunteer Experiences (Agency/Phone/Position):
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2 References (non-relative): References will be checked (name/relationship):
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Have you been convicted of a felony or misdemeanor in the past 15 years? *
If so, give date and nature of crime: Note: Please be advised effective July 2014, we are required by the State of NJ to do background checks on all volunteers.
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Health Limitations? If so, please describe: *
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Do you have a valid driver's license? We will need a copy. *
Drivers license # / State
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Vehicle Insurance Company and Policy Number: Note: We will need a copy of the front and back of your insurance card should you wish to be a driver. Everyone must submit a copy of their driver's license.
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Please select your volunteer type: *
Volunteer work Preferred *
If applying for meal delivery, type of volunteer?
If applying for meal delivery, type of volunteer?
Please tell us days you are able to volunteer (regular or substitute) Monday - Friday:
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Have you volunteered with a Meals on Wheels agency before? *
If so, when and where?
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Any comments or questions?
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Volunteer Hold Harmless Agreement
In consideration of participation in activities that I perform in a volunteer capacity on behalf of Meals on Wheels of Mercer County (MOWMC), I hereby waive, hold harmless and release MOWMC, its directors, employees, and agents for any claims, damages or injuries which I might sustain during the course of my volunteer activities. This waiver includes myself, my heirs or assigns from seeking any legal action whatsoever against MOWMC, its successor organizations or representatives thereof.
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