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Meals on Wheels Driver

Thank you for your interest in volunteering with us! Please complete the form below so we can learn more about you!
PERSONAL INFORMATION
Name*

First NameLast Name
Phone Number*

Area CodePhone Number
E-mail*
AVAILABILITY & COMMITMENT
Days Available (check all that apply):*

MondayWednesdayFriday
EXPERIENCE & MOTIVATION
Briefly tell us why you're interested in being a Meals on Wheels volunteer driver:*
Previous volunteer or delivery experience (optional):
CLEARANCES & COMPLIANCE

(To be completed prior to beginning volunteer duties)
I will obtain a Level One Fingerprint Clearance Card*

YESNO
I will complete a Central Registry Background Check*

YESNO
I confirm I have a valid AZ Driver’s License*

YESNO
I maintain current auto insurance & vehicle registration*

YESNO
I am comfortable working independently and can follow route directions.*

YESNO
ACKNOWLEDGMENT & SIGNATURE
I affirm that the information provided is accurate and complete. I understand and agree to fulfill all volunteer requirements as outlined by the Verde Valley Senior Center’s Meals on Wheels program. I authorize the Verde Valley Senior Center to conduct background checks as necessary.
Signature*

Clear
Date*

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

Meals on Wheels Driver