Volunteer with City Fare

Name *

Date of Birth *

Email *

Home Phone *

Work Phone

Cell Phone

Street Address *

City *

State *

Are you employed? *

If yes, where?

Have you ever been convicted of a felony? *

How did you hear about us?

In case of emergency, contact:

Name *

Address *

Phone *

Relationship *

Driver's License Information

Do you have a valid driver's license? *

Issuing State *

License Number *

Expiration Date *

Vehicle Information

Do you have use of a reliable vehicle? *

Do you have proof of insurance? *

If yes, what carrier?

Policy Number

Volunteer Preferences

Geographic area preferred *

Availability *

Personal References:

List below two people not related to you, whom you have known for at least 1 year:

Reference One:

Name *

Phone Number *

How long have you known this person? *

In what capacity? *

Reference Two:

Name *

Phone Number *

How long have you known this person? *

In what capacity? *

Volunteer with City Fare

In case of emergency, contact:

Driver's License Information

Vehicle Information

Volunteer Preferences

Personal References:

Reference One:

Reference Two:

Affiliate Member of the United Way of Delaware Donor Designation Code 748

Affiliate Member of the United
Way of Delaware
Donor Designation Code 748