Interested in Volunteering? Complete the application and a Volunteer Coordinator will be in touch soon! Date of Birth * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year192019211922192319241925192619271928192919301931193219331934193519361937193819391940194119421943194419451946194719481949195019511952195319541955195619571958195919601961196219631964196519661967196819691970197119721973197419751976197719781979198019811982198319841985198619871988198919901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012201320142015201620172018201920202021 First Name * Middle Name * Last Name * Street Address * Apt # City * Zip Code * Home Phone Work Phone Cell Phone * So, that we can text you in case of emergency or for your route reminder. Cell Carrier * Email preferred Would you like a weekly reminder? SelectYesNo If yes, how? SelectTextEmailPhone Call Emergency Contact First Name * Emergency Contact Last Name * Emergency Contact Relationship * Emergency Contact Phone * Emergency Contact Phone Type * SelectHomeWorkCell Volunteer Locations Please select any communities/delivery areas you prefer. To choose multiple options, hold the Ctrl button while selecting. AlvaradoAvalonBardwellBlooming GroveBristolBurlesonCleburneCorsicanaDawsonEnnisFerrisFrostGodleyGrandviewItalyJoshuaKerensLillianMaypearlMidlothianMildredMilfordOvillaPalmerRed OakRiceRio VistaRockettSardisVenusWaxahachie What days? What days you are interested in volunteering. Monday Tuesday Wednesday Thursday Friday Saturday - AniMeals (Once a Month) How often would you like to volunteer per week or month Once a week Two times a month Monthly As Needed Would you be willing to substitute? SelectYesNo Fill-in volunteers are sometimes needed if a route is open or a volunteer cancellation occurs. Are you volunteering with a group, school or company? SelectYesNo If yes, what group, school, or company? Will you need verification of volunteer hours? * - Select -YesNo Information on who and how to notify? Driver's License Number State Issued - None -AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming Expiration Date Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20202021202220232024202520262027202820292030 Date Issued Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year1920192119221923192419251926192719281929193019311932193319341935193619371938193919401941194219431944194519461947194819491950195119521953195419551956195719581959196019611962196319641965196619671968196919701971197219731974197519761977197819791980198119821983198419851986198719881989199019911992199319941995199619971998199920002001200220032004200520062007200820092010201120122013201420152016201720182019202020212022 Auto Insurance Company Insurance information is required. A copy of your insurance card and valid driver's license will be need to be provided to MOWNCT.. Consent for Criminal Background Check * I hereby give permission for Meals on Wheels North Central Texas to obtain information relating to my criminal history record through Public Data, an online resource for public records from local, state and federal agencies. The criminal history record, as received from the reporting database, may include arrest and conviction data, as well as plea bargains and deferred adjudications. I understand that this information will be used, in part, to determine my eligibility for volunteering with this organization. I also understand that as long as I stay a volunteer with this organization, the Criminal Background History Records may be repeated at any time. I understand that I will have an opportunity to review the Criminal History and a procedure is available for clarification, if I dispute the record as received. -Select-YesNo Photo Release * I hereby give permission for Meals on Wheels North Central Texas to use my likeness in a photograph in any and all printed publications, as well as online and video-based materials as approved by Meals on Wheels. I understand that there will be no monetary compensation now or in the future for use of my likeness. I am at least 18 years of age. -Select-YesNoI am under the age of 18 Applicant Agreement * I have agreed to volunteer my services to Meals on Wheels North Central Texas. I hereby release Meals on Wheels and its officers, directors, employees, and volunteers from any liability for any loss, cost, or damage to me or my property arising out of or in connection with any other volunteer work. I understand that while volunteering for Meals on Wheels North Central Texas I may have access to information and records, which are confidential in nature. I will not breach the client’s/participant’s privacy nor discuss confidential information with anyone. In addition, I understand that additional requirements include providing: • Valid driver license • Proof of insurance • Use of personal vehicle • Pass background check • Complete volunteer orientation/training CAPTCHAThis question is for testing whether or not you are a human visitor and to prevent automated spam submissions.