Give Help - COVID-19 Volunteers Question Title * 1. Disclaimer: I consent that information collected in the survey by United Way Centraide North East Ontario may be shared with partnering charities to fill available volunteer opportunities. I consent to the disclaimer OK Question Title * 2. Contact Information Name Organization Address Address 2 City/Town Province Postal Code Country Email Address Phone Number OK Question Title * 3. Have you volunteered in the last three years? Yes No If you have volunteered, please indicate the name/s of the organization and contact person/s. OK Question Title * 4. Do you have any of the following health symptoms Fever Cough Difficulty Breathing OK Question Title * 5. Are you bondable? Yes No OK Question Title * 6. As a volunteer, what is your area of interest? Grocery Shopping & Delivery Grocery Pick Up & Delivery Prescription Pick Up & Delivery Friendly Voice - Social Support - Telephone calls I want to make and donate fabric masks Other Other (please specify) OK Question Title * 7. Do you have a valid drivers license? Yes No OK Question Title * 8. Do you have access to a personal insured vehicle? Yes No OK Question Title * 9. Do you have access to a desktop computer? Yes No OK Question Title * 10. Do you have access to the Internet? Yes No OK Question Title * 11. AVAILABILITY - What days of the week are you available SUNDAY MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY Other (please specify) OK Question Title * 12. What are your hour preferences Mornings (AM) Afternoon (PM) Other (please specify) OK Question Title * 13. Any additional Information you would like to share - Please enter here OK Thank you for your interest in showing your Local Love during this Global Crisis. We will be in contact very soon. OK DONE
