Before you begin filling out the Volunteer Form please read the
Volunteer Policies and confirm that you can abide by these required policies.
* Note: Please fill out all fields to complete the application. All fields are required.
Are you a legal resident of the United States:
Your Phone #:
Emergency Contact Name:
Emergency Contact Phone #:
Level of education:
Languages you speak:
How did you find out about ASSIST:
Please share your reasons for wanting to volunteer with ASSIST:
Do you have any previous work volunteering? Please explain:
What are your interests and/or skills:
Do you have any physical limitations:
Do you have any physical or mental health impairments, including alcohol or drug usage which would affect your ability in terms of skill, attitude, or judgement to perform your volunteer duties?
If yes, please explain:
We are seeking volunteers who can work 2 days per week, for a total of approximately 4 - 5 hours for the week. (The initial two weeks may require more time with the new Care Receivers)
Please select your time preferences on the days you are available
AM = Before Noon
PM = noon - 5p.m.
Any = Available AM or PM
Neither = Not available that day
Are you prepared to complete 4 hours of training?
Are you prepared to attend the once a month support meeting?
Does your schedule permit you to attend meetings during the work day?
Can you commit to be an ASSIST volunteer for at least one year?
I understand that a background check is required for all potential volunteers and that before becoming a volunteer I will need to provide additional details (social security, date of birth, vehicle model, driver's license #) to ASSIST so that a background check can be performed.