Volunteer to Help Seniors - Sign Up
* * THIS FORM IS FOR VOLUNTEERS: if you're looking for help instead call 831-427-3435 * *

The Santa Cruz Volunteer Center (scvolunteercenter.org) is recruiting healthy volunteers to help local seniors during the ongoing Coronavirus pandemic. We are looking for volunteers to help get food to seniors so that they don't need to put themselves at risk by going grocery shopping.

If you are interested in volunteering your time to help out, please complete this form. When you submit it, we'll send you an email with additional information (including a background check release form).

Example volunteer roles include (but are not limited to) helping grocery shop, helping deliver food, etc.
Email *
First Name *
Middle Name
Last Name *
Mobile Phone Number *
Home Phone Number *
Birthdate *
You must be 21 or older.
Address Street *
Address City *
Address State *
Address Zip *
Are you able (and willing) to lift 25 lbs? *
Can you speak any languages other than English? *
Which ones?
Due to the high costs of on-boarding and background check screening, we are looking for volunteers who are willing and able to commit to a minimum of 1 grocery trip per week for the next 4 weeks. Are you able to make this commitment? *
Availability *
Additional availability information?
Optionally, are you potentially willing to deliver food to the household of someone that has been medically quarantined? *
Someone might be medically quarantined if, e.g. they were diagnosed with COVID-19.
Optionally, instead of volunteering as a grocery shopper, are you potentially willing to volunteer and help coordinate the Grocery Shopper Program remotely? *
The Grocery Shopper Program is largely coordinated by several volunteers who use their computer to work remotely from their house (one day a week for 3-4 hours) answering calls and sending emails. If you answer "yes" to this question, we'll follow up with you to tell you more. If you end up helping out as a remote coordinator, we'll train you in everything. You'll also be working with other volunteers and Volunteer Center staff. We really need more volunteers to help out as coordinators, so if you're willing do to this then we're going to try and steer you in this direction :)
Optionally, we occasionally get requests from seniors for help with yard work. Our program is specifically to help with groceries, so in general we have to tell people "sorry, but we can't help," but let us know if you'd be willing to occasionally help a senior with yard work and we'll reach out to you the next time we get a request like this.
Even if we reach out, you'll be under no obligation to say "yes"
Clear selection
Never submit passwords through Google Forms.
This form was created inside of Volunteer Center of Santa Cruz County. Report Abuse