First Name:
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Last Name:
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Street Address:
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City:
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State:
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Zip:
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Home Phone:
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| Birthday:
/
/
(mm/dd/yyyy) |
| In case of emergency, notify: |
Name:
Phone:
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As a Junior Volunteer, you may assist
residents with the following services:
- Transporting wheelchair residents to activities,
in-house appointments (Beauty Shop, etc.).
- Escorting residents’ outdoors.
- Assisting with small or large group activities.
- Individual visitation (i.e., conversation,
games, reading, writing letters)
- Shopping for residents.
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I wish to be a Junior Volunteer
at Phoebe Home because:
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I would like to spend time
with elderly residents because:
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Hobbies, personal interests:
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Clubs and/or church I belong
to:
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Day(s) and time(s) I am
available to volunteer:*
*If possible, it is helpful to choose a consistent schedule for volunteering; same day(s) and
time(s) weekly. Please alert staff about pending absences for vacations, personal plans, etc. |
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I,
(name of prospective jr. volunteer),
understand I'll need to abide by all rules and
expectations for Jr. Volunteers at Phoebe Home.
I
(name of Parent or Guardian) understand that
I am identifying myself as the parent or guardian
of
(name of youth) and he/she has my permission
to volunteer at Phoebe Home. I
understand that, should either party be dissatisfied
with the volunteer experience, the volunteer
department and/or the individual volunteer have
the right to end the volunteer assignment at
any time.
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