Volunteer Form Volunteer form There was an error trying to submit your form. Please try again. Please note that you are not a volunteer through Serve a Senior. The purpose of our website is only to give people information about seniors in facilities and in communities that would like visits. The information disclosed about these seniors list some of the things that they enjoy as well as items that they may need. For their privacy and protection, their full names and other personal information are not listed on this website. You will be given these senior's names and where to find them by the facility. This is not a contract and you are not obligated by filling it out. Your information will be forwarded to the facility for their reference. First Name * Enter your first name This field is required. Last Name * Enter your last name This field is required. Phone Number * Enter your phone number This field is required. Email Address * Enter your email address This field is required. Volunteer Areas of Interest Check all that apply Buying Christmas Gifts Buying Birthday Gifts Buying other needed items Reading to resident Talk about faith (if resident asks & agrees) Visiting the resident If visiting resident, how often Describe how often you can visit This field is required. Taking a walk with resident Select where you'd like to take walks Inside Facility Outside Grounds Trips away from facility Helping with needed tasks Explain the specific tasks you can help with (like making calls with them to help navigate automated systems, helping them make medical appointments, helping them fill out forms, etc.) Other volunteer details not covered above Please provide any additional information or details. Submit There was an error trying to submit your form. Please try again.
