Volunteer Application  

                 *Print Form and Mail to: Community Relations
                                   34570 State Highway 10, Suite, 1 Walton, NY 13856                

The Arc of Delaware County welcomes volunteers and is committed to utilizing your valuable gift of time in a meaningful way.

Information gathered on this form is only a first step in understanding your abilities and will be shared appropriately with our respective programs.  Additional follow up by an Arc program will be made accordingly.  All volunteers need to comply with the organization’s governing regulations, policies and procedures.  These will be explained as details around volunteer assignments are confirmed.

Thank you very much for your interest in volunteering at The Arc of Delaware County where people of all ages are enabled to meet the challenge of their disabilities with a growing sense of personal dignity and independence.

NAME:____________________________________________

ADDRESS:_______________________________________________

HOME PHONE #:_________________

WORK/OTHER PHONE #:___________________

EMAIL:_________________

I am a: (Check all that apply)

(  ) Student        (  ) Adult        (  ) Senior        (  ) Family member of someone who receives services

(  ) Arc Member        (  ) Arc Employee        (  ) Some who receives services from The Arc

(  ) Volunteer Representing a local organization/business called:__________________

We understand that sometimes individuals wish to give their time in whatever way is beneficial to the people we serve by having our organization assign tasks.  We would also appreciate if you would like to share particular interests and/or talents with us.

Special Areas of Interest (check all that apply)

Working with the people and families we serve...

(   )        Providing entertainment, describe: ____________________________________________

(   )        Arts and crafts instruction, describe: ___________________________________________

(   )        Assisting in recreational/social events (i.e. Arc Bowling Club, Valentine’s parties, etc.)

(   )        Working with seniors who have disabilities

(   )        Working with children who have special needs or delays

(   )        Providing family companionship, visitation and friendship

(   )        Providing family respite (filling in or a few hours during care givers absence)

Special Events/Fund Raising...

(   )         Annual Arc of Delaware Co. Bike-A-Thon (held first Sat. in May can include: assisting with preparatory tasks; day of event 9-2; post-event)

(   )         Annual Achievement Awards Dinner (normally held first Friday in June)

(   )         Holiday Celebrations & Parties (i.e. Halloween parties, Christmas Parties, etc.)

Administrative tasks...

(   )          Mailings

(   )          Office/Clerical Assistance

(   )          Participating on A Committee

Maintenance and Construction...

(   )         General maintenance and handy work

(   )         Gardening and yard work

(   )         General construction

(   )          Painting

(   )         Other: __________________________________________________________________

  Miscellaneous...

(   )          I would like to: ___________________________________________________________

(   )          I like variety and don’t have a preference at this time.  I’d consider volunteering where   I’m most needed.

Interests, Skills and Hobbies:

Do you have any special ones?  Please share: _________________________________________

___________________________________________________________________________

My availability to volunteer is (check all that apply knowing dates/times are to be determined):

(   )          Daily at these specific times: ________________________________________________

(   )          In the evening

(   )          Weekly

(   )         Periodically

*Please note: This is preliminary information. Please drop it off, or mail it to our facility at The Arc of Delaware County , 34570 State Hwy. 10, Walton , NY 13856 ATTN: Community Relations.

THANK YOU