WCH - Rosh Hashanah Package Delivery 2026 - Adults and Family Volunteer Form

DOROT's Rosh Hashanah Package Delivery - Westchester Volunteer Registration Form

September 2026
Thank you for volunteering for DOROT's Package Delivery.

For more information, please visit our website HERE.

We welcome individuals, families with children over 10 and adult pairs as volunteers.

If you are planning to volunteer with another adult as a pair, please remember each adult must register separately.
Are you volunteering as:
Parent/Guardian 1 Name

First NameLast Name
Parent/Guardian 1 Address

Street Address

Apartment (If Applicable)

CityState

Zip Code
Name

First NameLast Name
Address

Street Address

Apartment (If Applicable)

CityState

Zip Code
Preferred Email
example@example.com
Preferred Email Type
Preferred Phone #
Format: (000) 000-0000.
Preferred Phone Type
Gender:
Birth Date

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

First NameLast Name
Parent/Guardian 2 Address (if different from above)

Street Address

Apartment (If Applicable)

CityState

Zip Code
Parent/Guardian 2 Email
example@example.com
Parent/Guardian 2 Email Type
Parent/Guardian 2 Phone Number
Format: (000) 000-0000.
Parent/Guardian 2 Phone Number Type
Parent/Guardian 2 Birth Date

MonthDayYear
Parent/Guardian 2 Gender:
Child 1 Name

First NameLast Name
Child 1 Date of Birth
Child 1 Age
Child 1 Gender:
Child 1 Email (if applicable)
example@example.com
Additional Children
Are you a college student?
What school do you attend?
How did you hear about THIS Package Delivery event?
If Other, please specify:
I will volunteer to visit an older adult in their home.
I will pick up the package sometime between 10am - 4pm from DOROT's office, 925 Westchester Ave, Suite 200, White Plains, NY on:
I understand that:
- Visit will be scheduled directly with the older adult at a mutually convenient time.
- Visits are expected to take place anytime between Tuesday September 15th and Sunday September 20th.
- 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 Thursday, September 10th, at 5:30 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.
I acknowledge and agree to the bullet points above.
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:
Country Issued:
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.
Have you, since attaining the age of 18, been convicted of a criminal offense?
Today's Date

MonthDayYear
Date
Enter your initials
Just one more thing! You indicated you are volunteering as part of an adult pair.

Please provide the name and email of the adult who will be joining you.
Name of the adult who will be joining you:

First NameLast Name
Email of the adult who will be joining you:
myfriend@volunteeringtogether.com
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 Rosh Hashanah Package Delivery - Westchester Volunteer Registration Form

Just one more thing! You indicated you are volunteering as part of an adult pair.