Volunteer Application Form

Volunteer Application Form

Volunteer Application Form


    YesNo


    DriverKitchen helperAdministrative helperFuture Board Member


    DailyWeeklyEvery other weekMonthlySubstitute only


    MondayTuesdayWednesdayThursdayFriday


    YesNo


    YesNo

    ?

    Confidentiality. I hereby understand that any and all information which I may receive regarding any client of ECHO Meals on Wheels (ECHO MOW) is to remain confidential. I hereby agree to not discuss any such client information which I may receive through my volunteer activities with anyone.

    Release of Liability. I hereby release ECHO Meals on Wheels West, Inc., from any claim or liability for any injury or illness resulting to any minor or non‐applicant who may accompany a volunteer from time to time during the volunteer’s activities with ECHO MOW, where such injury or illness is not occasioned by any fault or neglect on the part of ECHO MOW.

    Certification of Information Provided. I hereby certify that I, the undersigned applicant, have personally completed this application. I declare that the facts contained in this application and any supporting documents are true and complete to the best of my knowledge. I understand that any false information or omission will disqualify me from further consideration for volunteering and if discovered at a later date, will be justification for my dismissal from volunteering.

    CONSENT FOR MINOR UNDER AGE 18 TO PARTICIPATE IN VOLUNTEER ACTIVITIES

    ECHO Meals on Wheels West, Inc.

    4600 West Genesee Street, Syracuse, NY 13219

    (315) 487‐2878