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Looking to be a Volunteer? Sign up today and get added to our list so that you can begin serving your community.

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Beneficiary for Death Accident Insurance (MEDICARE RECIPIENTS ONLY)

Volunteers will not engage in the following activities: Electoral activities, Voter Registration, Voter Transportation to polls and efforts to influence legislation, Volunteers will not give religious instruction, Conduct worship services, or engage in proselytization as part of their duties. Volunteers will not receive a fee for volunteer service from service recipients, their legal guardian, or members of their family or friends. Volunteers will not engage in activities which would otherwise be performed by an employee or which would supplant the hiring of or result in the displacement of employed workers or impair existing contracts for service.

I, understand that if I use my personal automobile to/from my volunteer work station, I will arrange to keep in effect automobile liability insurance equal to or greater than the minimum required by the state.

I, by completing and submitting this form, declare the above information is true and accurate to the best of my knowledge.