Community Care Durham

Volunteer Form

Yes, I am interested in volunteering with Community Care Durham, please have a representative contact me:

*Required information

Title:
First name:	*
Last name:	*
Company/Organization:
Address line 1:	*
Address line 2:
City/Town:	*
Province:	*
Postal code:	*
Home phone:	*
Work phone:
E-mail:

Please check your areas of interest:

Home Support Volunteer Opportunities:

Transportation:		Friendly Visiting:
Meals on Wheels:		Telephone Reassurance:
Luncheon Out:		Office Support:
Foot Care Clinic:

Respite (Caregiver Relief) - Day Program Opportunities:

Pickering:
Newcastle:
Uxbridge:

COPE Mental Health Volunteer Opportunities:

Individual Support:
Group Support:

Other Volunteer Opportunities:

Board Member:
Local Advisory Committee Member:
Fundraising and Events:

Please check where you would like to volunteer:

Ajax-Pickering:		Scugog:
Brock:		Uxbridge:
Clarington:		Whitby:
Oshawa:

Other Opportunities:

Brokered Services

Home Help: (light housekeeping)
Home Maintenance: (yard work & snow shovelling)

Please check carefully that all of your information is accurate and complete. All information is strictly confidential and is intended for the sole use of Community Care Durham. For information about our privacy policy, view Community Care Durham's Privacy Policy.