CARE Newsletter October 2017
CARE Newsletter July 2017
CARE Newsletter April 2017
CARE Newsletter September 2016
Are you a veteran YesNo
Is your spouse a veteran YesNo
Organization / Description of Service / Dates (From/To)
Company / City,State / Type of Work / Dates (From/To)
Client Opportunities: Friendly VisitsFriendly Phone CallsTransportationRespite CareHousekeepingChoreMinor Home RepairYard WorkGrocery ShoppingSnow RemovalPhysical Fitness ProgramFood Distribution Program
Fundraising/Office Opportunities: Brat SalePork Chop DinnerOffice AssistancePie SocialBake & Craft SaleBoard/Committee MemberSilent AuctionTouching Tables for Seniors
When are you available?
How did you learn about the C.A.R.E. program? Community EventFriend/Family MemberLocal NewspaperMedical ProfessionalBenton CountyCommunity PresentationC.A.R.E. NewsletterC.A.R.E. WebsiteHeritage Home HealthOther (please explain)
List of References
(Please list 3 references)
Name / Relationship / Phone / Best Time to Contact
Volunteer Background/Publicity/Special Accomodations/Signature Agreements
I hereby give my consent for Foley Area C.A.R.E. to contact my references and to conduct a routine BCA background check. The information that I have provided in this application is true and correct to the best of my knowledge. YesNo Initials: Date:
I hereby give Foley Area C.A.R.E. permission to use my name and photograph to promote the Foley Area C.A.R.E. program. This permission includes publicity, fundraising campaigns, and sharing photographs with other media for these purposes.YesNo
Do you require any special accommodation from Foley Area C.A.R.E. to perform the volunteer responsibilities as outlined in the orientation material?YesNo If YES, what special accommodation do you require?
If I am selected to participate in the C.A.R.E. program, I understand and agree to adhere to the volunteer policies and procedures as presented to me by the administrators of the Foley Area C.A.R.E. program.