Volunteer Profile

Volunteer Profile
By completing the Cabarrus Meals on Wheels Volunteer Profile, you agree that you have read and understand the Volunteer Delivery Guidelines.

>> View the Volunteer Delivery Guidelines

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Today's date*

MonthDayYear
NC Driver's License Number*
Auto insurance company*
Insurance policy #*
Name*

PrefixFirst NameLast Name
Spouse

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Cell phone*
Please enter a valid phone number.
Work phone
Please enter a valid phone number.
Email Address*
example@example.com
Date of birth*

MonthDayYear
Date
Employer/Occupation
Retired from:
Ethnicity

CaucasianAfrican AmericanHispanic/LatinoAsianOther
Gender

MaleFemale
Emergency contact name*
Relationship*
Phone number*
Please enter emergency contact phone number
Other volunteer work
How did you hear about us?*

NewsFriendChurchOther
Will you deliver with a partner?*

YesNo
Partner name
Are you available to be called as a substitute driver?*

YesNo

Please list name(s) and birth date(s) of all children who will deliver with you

We ask for a 6 month commitment. Are you able to commit to this?*

YesNo
Why did you choose to volunteer with Cabarrus Meals on Wheels at this time?*
What day(s) are you available?*

MondayTuesdayWednesdayThursdayFriday
Preferred day(s) of delivery*

MondayTuesdayWednesdayThursdayFriday
Anticipated start date*

MonthDayYear
Date
How many times per month are you able to deliver?*
Would you be interested in helping promote Cabarrus Meals on Wheels through your church or civic group by public speaking, pamphlet handout, volunteer recruitment, or fundraising? In what area?*

References: Please note if personal, professional, or educational*

	Name	Phone #
Reference 1
Reference 2

Volunteer Agreement
- I have received a copy of the Cabarrus Meals on Wheels (CMOW) Volunteer Guidelines.
- I agree to respect the confidentiality of my contacts with CMOW clients and will keep information confidential that is disclosed to me about clients' names, personal information, and diagnosis.
- I have current automobile coverage for my vehicle and will keep it for as long as I drive for CMOW.
- I agree to indemnify and hold CMOW harmless of and from any and all claims, demands, losses, suits, or all other damages of any kind arising from my activities as a volunteer for Cabarrus Meals on Wheels.
Volunteer Signature*

Clear
Date*

MonthDayYear
Date
Please verify that you are human*
Should be Empty: