Same Day Pay Interest Form

Interested in earning Same Day Pay while helping your community? Complete the form below to be considered for one of our limited Same Day Pay opportunities during ODAAT's Annual Candlelight Vigil.

Please read carefully before submitting:

Completing this form does not guarantee a Same Day Pay assignment.
If you do not receive a confirmation email, you have not been assigned to work. Please do not report expecting an assignment.
A limited number of Same Day Pay positions are available.
Participants must be available for the entire shift (9:00 AM–4:00 PM).
Selected participants are expected to arrive by 8:30 AM for check-in and orientation.

Date

Name

First NameLast Name

Date of Birth

Date

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Email

example@example.com

Current Place of Residence. Please provide the address where you are currently staying (shelter, recovery house, family member's home, etc.).

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Emergency Contact Name

First NameLast Name

Emergency Contact Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Emergency Contact Relationship

Have you participated in ODAAT's Same Day Pay Program in 2025? Your answer will not affect your eligibility or selection for this opportunity.

If yes, approximately how many times?

Have you ever been dismissed or removed from an ODAAT Same Day Pay assignment?

If yes, please explain.

Are you available to report by 8:30 AM for check-in and orientation and work from 9:00 AM–4:00 PM?

How will you arrive at 2815 N. 17th Street, Philadelphia, PA 19132?

Do you have a valid government-issued photo ID?

Attach a picture of your valid picture ID:

Transportation to the event is not provided. Transportation from the event to assigned worksites will be provided. If assigned to a worksite, how do you plan to travel there?

T-Shirt Size

How did you hear about this opportunity? Check all that apply.

Participation Acknowledgement:

I understand that submitting this form does not guarantee a Same Day Pay assignment.
I understand that I must receive an official confirmation email from ODAAT before reporting to work.
I understand I must be available for the entire shift (9:00 AM–4:00 PM).
I understand transportation to the event is my responsibility.
I understand transportation from the event to the assigned worksite will be provided unless I choose to drive myself.
I understand I must return to 2815 N. 17th Street after completing my assignment in order to receive payment.
I understand work assignments may include indoor cleaning, outdoor cleaning, lifting, carrying equipment or supplies, neighborhood beautification, event support, and other general labor tasks.
I certify that I am physically able to safely perform these duties or will immediately notify ODAAT staff if I am unable to do so.

Work assignments may include:

Indoor cleaning
Outdoor cleanup
Neighborhood beautification
Event support
General labor
Other duties as assigned

Attire: Participants should arrive wearing: Comfortable clothing Closed-toe shoes Clothing appropriate for indoor and outdoor work Weather-appropriate attire 

Payment Information: At the conclusion of your assignment, all participants must return to 2815 N. 17th Street to check out and receive payment. Participants who fail to return may experience a delay in payment.

I acknowledge that participation in ODAAT's Same Day Pay Program involves physical activity and carries certain inherent risks. I voluntarily assume all such risks and agree to follow all instructions provided by ODAAT staff. I understand that work may involve lifting, carrying equipment or supplies, walking, standing for extended periods, and performing indoor and outdoor labor. In consideration for being permitted to participate, I release and hold harmless One Day At A Time (ODAAT), its officers, employees, volunteers, partners, sponsors, property owners, and affiliates from any claims, demands, injuries, damages, losses, or liabilities arising out of or related to my participation, except where prohibited by law. I understand that I participate voluntarily and that this acknowledgement applies to my participation in the August 13, 2026 Same Day Pay Program.

I acknowledge that I am representing ODAAT and its community partners while participating in the August 13, 2026 Same Day Pay Program. Weapons of any kind are strictly prohibited, and violence, threats, harassment, intimidation, drug or alcohol use, or any disruptive or inappropriate behavior will not be tolerated. I agree to conduct myself in a respectful, professional, and safe manner at all times and to follow all instructions provided by ODAAT staff and worksite supervisors. I understand that ODAAT reserves the right to immediately dismiss any participant whose conduct jeopardizes the safety, reputation, or mission of ODAAT or its partners. I further understand that dismissal from the program for misconduct may result in forfeiture of payment and disqualification from future Same Day Pay opportunities.

Signature