FamilyMeans Volunteer Application

Information About You

Contact Information

Emergency Contact Information

Work Experience

Volunteer Preferences


List three references. (At least 2 non-family members; please specify phone number given as day (d) or evening (e) number.) Please inform your references that we will be contacting them within the next 2 weeks after receipt of your application.

Reference 1

Reference 2

Reference 3

Respite Volunteers

The following questions are for RESPITE VOLUNTEERS ONLY to assist us in matching volunteers with an appropriate caregiver: