Passover Package Delivery 2026 - Adults and Family Volunteer Form

For more information, please visit our website HERE.

Are you volunteering as:

Parent/Guardian 1 Name

First NameLast Name

Parent/Guardian 1 Address

Street Address

Apartment Number

CityState

Zip Code

Name

First NameLast Name

Address

Street Address

Apartment Number

CityState

Zip Code

Preferred Email Type

Preferred Email

example@example.com

Preferred Phone Type

Preferred Phone #

Format: (000) 000-0000.

Gender:

Birth Date

MonthDayYear

Parent/Guardian 2 Name (complete they will also participate.)

First NameLast Name

Parent/Guardian 2 Address (if different from above)

Street Address

Apartment Number

CityState

Zip Code

Parent/Guardian 2 Preferred Email

example@example.com

Parent/Guardian 2 Preferred Email Type

Parent/Guardian 2 Preferred Phone #

Format: (000) 000-0000.

Parent/Guardian 2 Preferred Phone # Type

Parent/Guardian 2 Birth Date

MonthDayYear

Parent/Guardian 2 Gender:

Child 1 Name

First NameLast Name

Child 1 Birth Date

MonthDayYear

Child 1 Age

Child 1 Gender:

Child 1 Email (if applicable)

example@example.com

Additional Children

Are you a student?

How did you hear about THIS Package Delivery event?

If you chose Volunteer Website or Partner Organization above, please let us know which website or organization:

Me and my child(ren), age 10-17, will deliver a package to an older adult and stay for a 30-45 minute in-person visit.

Based on the need of the older adults, I understand that I will either deliver a package to an older adult and stay for a 30-45 minute in-person visit OR deliver the package to an older adult and make a 15-20 minute friendly phone call later that day.

Disclaimer: If you have a strong preference for a visit or call, please register for an early timeslot. Please note that we cannot guarantee preferences.

FAMILY: We will pick up the package at the following location and time and deliver it to an older adult who lives on the

ADULT: I will pick up the package at the following location and time and deliver it to an older adult who lives on the

East Side Family - Please select date and time

West Side Family - Please select day and time

East Side Adult - Please select date and time

West Side Adult - Please select date and time

I have volunteered for a DOROT Package Delivery in the past.

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

Other

Driver's License State

Expiration Date

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 refrain from providing medical, legal or financial advice, and will not assist clients with such matters directly;
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.

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

Today's Date

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.

DOROT's Passover Package Delivery