Meals on Wheels Volunteer Application
Ready to help deliver hot meals & a warm smile?
Home Address - street, city, zip code
Optional : Gender
Prefer not to say
Optional: Are you a Veteran
Emergency Contact - name, phone number, relationship
Member of existing Volunteer Group:
Desired Delivery Area - check all that apply
I am interested in
driving for Meals on Wheels
meal packing for Meals on Wheels
volunteering at Fort Bend Seniors Senior Centers
telephone reassurance (calling home-bound seniors)
fundraising and special events
Days Available - check all that apply
Where did you hear about Meals on Wheels?
Do you speak any languages other than English?
Do you have any limitations that may cause difficulty performing essential functions of the volunteer position? If yes, explain:
Have you ever been arrested or convicted of any offense? If yes, please explain providing dates, charge, disposition, and other appropriate details.
Required for Volunteer Drivers : Automobile Insurance Company
Required for Volunteer Drivers : Insurance Policy Number
Required for Volunteer Drivers : Driver's License Number
Required for Volunteer Drivers: State that driver's license was issued in:
I have read the Meals on Wheels, Inc. Volunteer Code of Ethics in the Driver Guidelines Brochure and agree to abide by these guidelines set by the Meals on Wheels, Inc. Board of Directors.
I agree that all client information I receive, whether obtained by direct contact with clients and their families or information from MOWI staff is to be held in strict confidence in order to protect the rights of all clients.
Additionally, I agree to identify and hold Fort Bend Seniors Meals on Wheels harmless of and from any and all claims, demands, losses, suits, or all other damages of any kind arising from my activities as a volunteer for Fort Bend Seniors Meals on Wheels.
Date of birth
Last 4 digits of Social Security Number
This is required for the background check we run on all volunteers. Information is stored securely and never distributed or accessible to outside parties.
Type full name to authorize background check (details above)
Date of Application (Today's Date)
A copy of your responses will be emailed to the address you provided.
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