DOROT Winter Package Delivery Volunteer Registration Form

DOROT Winter Package Delivery Volunteer Registration Form

Online registration closes on January 20.
Note that this form is for volunteers ages 18+.
Families with children ages 10 – 17 may contact packagedelivery@dorotusa.org to find out about volunteering for this event.
Name *

First Name Last Name
Email *
example@example.com
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Primary Phone # *
Secondary Phone #
Sunday, January 24:
Primarily Upper East Side Drop-offs

Monday, January 25:
Primarily Upper West Side Drop-offs
I will pick up the package at DOROT, 171 West 85th Street (off Amsterdam Avenue) on the following day and time and deliver it to an older adult who lives on the Upper East Side (Sunday, January 24) or Upper West Side (Monday, January 25) of Manhattan. *

Yes
*
I have delivered a package to a DOROT senior in the past. *

Yes No
Are you a student? *

High School College No
Please review the CDC guidance: https://www.cdc.gov/

If you are at higher risk for severe illness, we ask you not to volunteer for this event and join us another time. DOROT's number one priority is the health and safety of our employees, volunteers, and older adults.
I am age 18+ and I am comfortable volunteering for this event? *

Yes
Please note that a government issued photo ID is required for all volunteers.
For contactless verification of your identity, upload a photo of the front of your government issued photo ID, such as a U.S. driver’s license or state ID or passport. Please remember to have your ID with you when you come to DOROT. *

Browse Files

Cancel of
If you do not want to upload a picture of your government issued photo ID you can provide the ID number from your U.S. driver's license or state ID or passport in the textbox below. Please remember to have your ID with you when you come to DOROT.
ID Number from government issued photo ID
Type of ID *

Driver's License Passport
Driver's License State
Date of issue *

Month Day Year
Date
In order to protect the health and safety of our older adults, on the day of the program you will be asked following questions about your exposure to COVID-19. Be on the lookout for an e-mail from DOROT on the morning of your pick up and respond to it prior to volunteering.
- Have you experienced COVID-19 symptoms in the past 14 days? You can review the symptoms here: https://forward.ny.gov/protect-yourself-and-your-family-coronavirus-covid-19
- Have you had a positive COVID-19 test in the past 14 days?
- Have you had close contact with confirmed or suspected COVID-19 cases in the past 14 days?
- In the past 14 days, have you traveled internationally or returned from a state identified by New York State as having widespread community transmission of COVID-19 (other than just passing through the restricted state for less than 24 hours)?
If you answer Yes to any of the questions above, we will ask that you not participate in this event.
Have you, since attaining the age of 18, been convicted of a criminal offense? *

Yes No
DOROT's Terms of Service

DOROT prides itself on providing quality programs and our efforts to ensure the safety and well-being of volunteers and older adults. As a DOROT volunteer, I accept and will adhere to the following standards of behavior when engaged in volunteer activities. I understand that DOROT may terminate my volunteer engagement at any time for any reason including failure to follow these guidelines.
- I will participate in required training programs, follow all rules and use the recommended policies and procedures;
- I will adhere to all local, State and Federal laws and behave with the highest level of professionalism and integrity in all of my interactions with clients, staff and other volunteers;
- I will preserve the confidentiality of information about program participants that has been entrusted to me;
- I will not use DOROT volunteer status for personal, business or financial gain.
I agree to DOROT's Terms of Service for volunteers. *

Yes
Date

Month Day Year
Date
Enter your initials *
Please check your responses carefully for accuracy. You will not be able to revise this form after submission.
Should be Empty: