Accessible Care Transport Volunteer Application Form

Volunteer Application
Accessible Care Transport, Inc. (ACT) is a locally operated non-profit corporation dedicated to providing safe, reliable, compassionate, and affordable transportation services to individuals in need of non-emergency medical care. We are committed to improving the quality of life within our community by ensuring that those facing mobility challenges, limited transportation options, or financial obstacles can access their medical appointments and essential healthcare resources. Our team consists of caring individuals who undergo thorough background checks and hold certifications in CPR, Defensive Driving, and PASS (Passenger Assistance, Safety & Sensitivity). We offer both wheelchair-accessible and sedan transport options to cater to your specific transportation requirements.
Personal Information
Name*

PrefixFirst NameLast Name
Birth Date*

MonthDayYear
Email*
example@example.com
Phone Number*
Format: (000) 000-0000.
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Address*

Street Address

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Volunteer Information
Which of the volunteering activities interest you?*
Please describe any previous volunteer experience and/or related skills.
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Hour Minutes

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Educational Background
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Date*

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Date
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Volunteer Application

Personal Information

Volunteer Information

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