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Volunteer Application

Join our dedicated team of volunteers making a difference in the lives of Leelanau County seniors.

Tell Us About Yourself

Fields marked with * are required

Personal Information

First Name *

Last Name *

Email *

Mobile Phone

Home Phone

Mailing Address

Street Address

City

State / Province

Zip / Postal Code

Emergency Contact

Emergency Contact Name

Emergency Contact Phone

Volunteer Skills

Please select all that apply:

Driver

Select ride type

Ride — Medical

Ride — Wellness

Friendly Phone Call

Friendly Visit

Respite

Grocery Delivery

Pharmacy Delivery

Library Delivery

Yard Clean-up

Volunteer Availability

When are you generally available?

Monday

Tuesday

Wednesday

Thursday

Friday

Mornings

Afternoons

Additional Notes

Volunteer Notes

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