Summer Package Delivery 2025 - Volunteer Registration Form

DOROT's Summer Package Delivery

Wednesday, July 16, 2025
Online registration closes on Friday, July 11th.

Note that this program is for individual volunteers ages 18+.

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

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

Street Address

Street Address Line 2

CityState

Zip Code
Gender*
Primary Phone #*
Secondary Phone #
How did you hear about THIS Package Delivery event?*

DOROT EmailDOROT WebsiteFriend or FamilyNYC Link Digital KioskSocial MediaWest Side RagUJA Federation of New YorkMoise Safra CenterAdvertisementVolunteer Website (such as NY Cares, Volunteer Match, NYC Service, etc.)Partner Organization (such as JCC Engage, Hunter Red Cross, Junior League, etc.)Other
If Other, please specify:
If you chose Volunteer Website or Partner Organization above, please let us know which website or organization:
I understand that I will deliver the package to an older adult who lives on the Upper West Side of Manhattan and stay for a 30 - 45 minute in-person VISIT.*

Yes
I will pick up the package at DOROT, 171 West 85th Street, on the following day and time: *
I have volunteered for a DOROT Package Delivery in the past.*

YesNo
A government issued photo ID is required for all volunteers age 18+. 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
Expiration Date*

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 imagine 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 Summer Package Delivery