INFORMATION ABOUT YOU First name: * Last name: * Street address: * City: * State: * Indiana Zip code: * Email Address * Phone number (home or cell): * Phone number (work): Date of birth (mm/dd/yyyy) * Employer (if retired, former employer): Any special skills that may help Meals on Wheels in other volunteer areas Activities, sports, hobbies, etc. Previous volunteer experiences DRIVER'S LICENSE AND VEHICLE INFORMATION Driver’s license number * State issued: * Expiration date: * Vehicle insurance company: * Expiration date: * EMERGENCY CONTACT INFORMATION First name: * Last name: * Relationship to you: * Phone number: * OTHER INFORMATION Areas of interest * Deliver meals regularly PRN Delivery Fundraising Events Committees Kitchen Board of Directors Other Days that you are available from 10:30am-12:30pm * Monday Tuesday Wednesday Thursday Friday A back ground check will be run on all volunteers at our expense. The following information will only be used for the background check. OUR POLICY: It is the policy of this organization to provide equal opportunities without regard to race, color, religion, national origin, gender, sexual preference, age, or disability. Please sign below by printing your full name, thereby giving us permission to run a background check through the Terre Haute Police Department. * Sex * Height * Race * Hair color * Eye color * CAPTCHAThis question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
