Volunteer Information
North Shore Area Partners
Full Name _________________________________________________________________________
Mailing Address ____________________________________________________________________
Daytime Telephone Number ___________________________________________________________
Evening Telephone Number ___________________________________________________________
Date of Birth _______________________________________________________________________
Availability
Mornings
Afternoons
Evenings
Anytime
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Please mark the following activities you are willing to participate in:

Lead simple exercises

Volunteer to provide respite care to a caregiver

Learn about Alzheimer’s Disease

Fold flyers for NSAP staff

Mail birthday cards to elders

Pick up prescriptions for elders

Take blood pressures

Visit a shut-in elders

Serve refreshments at events

Office-sit when staff is absent

Visit a neighbor

Interact with school children

Pick up mail for elders

Take an elder to Beauty Shop/Barber

Volunteer to shovel snow

Help an elder with meal preparation

Shovel snow for a fee of $_____*

Pick up recyclables

Help with publicity

Willing to share the warmth of your wood stove

Share garden produce

Give a ride to town for medical appointments

Rides to attend church

Pick up groceries and delivery to elders homes

__

Bake cookies or bars

__

Volunteer to do light housekeeping chores

__

Perform light housekeeping chores for a fee of
in a power outage
List any other activities you are able to help with:
$_____*
__________________________________

Help set up/clean up for NSAP events
__________________________________

Make a phone call to a shut-in elder
__________________________________

Volunteer to do simple home repairs
Is there anyone special you would like to help? If so,

Perform simple home repairs for a fee of
who? ______________________________
$_____*

Volunteer to do simple yard work

Perform simple yard work for a fee of $_____*
__________________________________
*Indicates Non-Volunteer Fee-Based Activities
Note: Volunteers providing transportation need to provide proof of insurance and a copy of their drivers license.