Volunteer Application

ElderNet provides a safety net for older and disabled adults to help them remain in their homes with dignity and strengthens food and financial security for all community members in need of support.

Volunteer Form
ElderNet provides a safety net for older and disabled adults to help them remain in their homes with dignity and strengthens food and financial security for all community members in need of support.
Which do you prefer to be contacted on?
How long have you lived in Pennsylvania?
Race (For Reporting Purposes Only)?
How would you like to help?
Driving to medical appts:
Essential errands to bank, pharmacy, etc
Pantry
Special Events
Grocery shopping
Friendly Caller
Friendly Visitor
Odd Jobs
Other Information Needed:

As part of ElderNet’s application process, we will need a few more pieces of information from you:

  1. A copy of your driver’s license or other government-issued ID. This will be used to complete a
    background check for all volunteers.
  2. Have you used any other first or last names? This will help complete the background check.
  3. A copy of your car insurance card. For volunteers who will be escorting participants only. We
    will also need updated insurance information when your policy is renewed or changed.
  4. Three references.

Reference 1

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Reference 2

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Reference 3

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