You Name

Daytime Phone No.

Email Address

Choose from any of the areas below (you may select more than one  by holding down  your "CTRL"):

COMMUNICATIONS:                            Choose one or more Fill out forms Clerical filing Make follow up phone calls Act as an in-house phone volunteer

COMPANIONSHIP: Choose one or more Visit shut-in, elderly, disabled or handicapped Offer senior caretaker support Prepare a meal in-home Watch someone overnight

CLEAN UP:                                            Choose one or more Light housekeeping Painting Shoveling snow Yard work for disabled and/or seniors Move heavy boxes

CHILD CARE:  Choose one or more Baby sitting (temporary) After-school care (for working single parent) Make/Donate maternity or baby items and furniture

EDUCATION:                                                                                  Choose one or more Budget planning Meal/Grocery planning Share parenting skills Tutor children

FIX-IT:                                                                                                        Choose one or more Plumbing Carpentry Electrical work Auto repair Appliance repair

TRANSPORTATION / DELIVERY: Choose one or more Help someone move Transport furniture Shop for the elderly or shut-ins Deliver groceries/hot meal Pick up used bedding Transport people to clinics and medical appointments

PROFESSIONAL:                                                                              Choose one or more Medical Assistance Dental assistance Legal assistance

AVAILABILITY:
TUESDAYS        MORN   AFT   EVE
WEDNESDAY  MORN   AFT   EVE
THURSDAYS    MORN   AFT   EVE

Our Clearinghouse Manager will confirm receipt of your submission during the business hours of 10am-2pm Tuesday thru Thursday.