Passover Package Delivery 2024 - Westchester Volunteer Registration Form

DOROT’s Passover Package Delivery - Westchester Volunteer Registration Form

Sunday, April 7, 2024
Note that this form is for individual volunteers ages 18+ or High School students who will be accompanied by a parent/guardian.

For more information, please visit our website HERE.
Name*

First NameLast Name
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Primary Phone #*
Secondary Phone #
Birth Date

MonthDayYear
Gender*
Are you a student? *

High SchoolCollegeNo
Name of High School
Name of Parent/Guardian who will accompany you:*

First NameLast Name
Address of Parent/Guardian who will accompany you:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number of Parent/Guardian who will accompany you:*
Email of Parent/Guardian who will accompany you:*
example@example.com
I understand my parent/guardian will receive an email asking them to register for this event.*

Yes, I understand.
How did you hear about THIS Package Delivery event?*

DOROT InviteDOROT WebsiteThe LOFTUJA Federation of New YorkUJA/J-TeenVolunteer NYAdvertisementFacebookInstagramFriend or FamilyOther
If Other, please specify:
Pick up the package(s) at DOROT’s office, 925 Westchester Avenue, Suite 200, White Plains, NY. Please choose the option that best suits your availability:*

Visit an older adult and bring a package to their home on Sunday, April 7. I will pick up the package on Sunday, April 7, between 10:30 am – 12:00 pm. I understand the older adult is expecting me to visit before 1:00 pm.Deliver the package and make a friendly phone call to 1-3 older adults. I will pick up the package on Sunday, April 7, between 10:30 am – 12:00 pm. I understand the older adult is expecting me to deliver the package before 1:00 pm. I will arrange a mutually convenient time to have a friendly phone call.
I acknowledge and agree to the bullet points below.*

Yes
I understand that:
- Visits are expected to take place on Sunday, April 7, immediately after picking up the package from DOROT.
- The older adult is expecting the in-home visit before 1:00 pm.
- Volunteers for in-home visits must have previously participated in other DOROT in-home volunteer visiting activities or must attend a 30-minute Zoom orientation on Tuesday, April 2, at 12:30 pm (details to follow in a separate email).
- Visits are expect to last between 30-45 minutes.
- Visits are not guaranteed but based on availability. If a visit is not available, I will delivery the package and make a friendly phone call, which is expected to last between 15-30 minutes.
I will pick up a total of:*
I understand that:
- Visits are expected to take place on Sunday, April 7, immediately after picking up the meal from DOROT.
- The older adult is expecting the in-home visit before 1:00 pm.
- Volunteers for in-home visits must have previously participated in other DOROT in-home volunteer visiting activities or must attend a 30-minute Zoom orientation on Tuesday, April 2, at 12:30 pm (details to follow in a separate email).
- Visits are expect to last between 30-45 minutes.
- Visits are not guaranteed but based on availability. If a visit is not available, I will delivery the package and make a friendly phone call, which is expected to last between 15-30 minutes.
I will pick up a total of:*
I have volunteered for a DOROT Package Delivery in the past.*

YesNo - I will mark my calendar and expect an invitation to a 30-minute Zoom orientation for new volunteers to be held on Tuesday, April 2, at 12:30 pm.
Please note that a government issued photo ID is required for all volunteers. Please provide the ID number from your government issued photo ID in the textbox below. Remember to have your ID with you when you come to DOROT. *
Type of ID*

Driver's LicensePassportOther
Driver's License State
Date of issue*

MonthDayYear
Date
DOROT's Terms of Service

DOROT prides itself on providing quality programs and our efforts to ensure the safety and well-being of volunteers and older adults. As a DOROT volunteer, I accept and will adhere to the following standards of behavior when engaged in volunteer activities. I understand that DOROT may terminate my volunteer engagement at any time for any reason including failure to follow these guidelines.
- I will participate in required training programs, follow all rules and use the recommended policies and procedures;
- I will adhere to all local, State and Federal laws and behave with the highest level of professionalism and integrity in all of my interactions with clients, staff and other volunteers;
- I will preserve the confidentiality of information about program participants that has been entrusted to me;
- I will not use DOROT volunteer status for personal, business or financial gain.
I agree to DOROT's Terms of Service for volunteers.*

Yes
Have you, since attaining the age of 18, been convicted of a criminal offense?*

YesNo
Today's Date

MonthDayYear
Date
Enter your initials*
A photographer will be taking pictures of the event. Please know that by participating, you may be photographed and your image may be used in DOROT’s public relations and fundraising materials. If you don’t wish to be photographed, please let the photographer know.

Please check your responses carefully for accuracy. You will not be able to revise this form after submission.
Should be Empty:

DOROT’s Passover Package Delivery - Westchester Volunteer Registration Form