Join Our Volunteers

Ready to volunteer? Fill out the form below or call us at 225.923.8000

NOTE: Volunteer orientation is usually held once a month. Depending on the frequency and response from volunteers, additional orientation/training sessions may be scheduled.




Application Information
First Name
Last Name
Street Address
City
State
Zip Code
Phone (###-###-####)
Birthdate (MM/DD/YYYY)
Email Address
Twitter @

I am interested in volunteering with: (check all that apply)
Meals on Wheels - Home Delivery
Meals on Wheels - Senior Centers
Activity Centers

Senior Olympics

Workforce Resources
Office / Administrative Support
Other (please specify)
I would like to offer my expertise in

In Case of Emergency:
Emergency Contact
Emegency Contact Number (###-###-####)

If you are volunteering as part of a group:
Company or Group
Contact Person
Phone Number (###-###-####)

Availability:
Please check the days that you are available to volunteer
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
How did you hear about EBR COA?    Friend
   Program Participant
   News Report / Article
   Internet
   Event
   EBR COA Staff
   Another Volunteer
   Advertisement

CONFIDENTIALITY AND RELEASE WAIVER AGREEMENT

Confidentiality Agreement
As a volunteer for EBR COA, I understand that there may be times I may come in contact with confidential and/or personal information. I acknowledge that the unauthorized disclosure of information would violate EBR COA's client right to privacy. I hereby recognize that it is my responsibility to protect such information and pledge to keep such information in absolute confidence. I futher acknowledge that should I violate this confidentiality agreement it may lead to an immediate termination from the volunteer program and legal action taken upon me by EBR COA to the full extent of the law based on the severity of the damages.

Release Waiver Agreement
I am to assist EBR COA in its sponsored events and do so voluntarily. I agree to hold EBR COA, its staff, volunteers, and participants harmless from all liability including those resulting in personal injuries, damages, claims and losses I may incur as a result of my participation in this sponsored event.

I further grant full permission to EBR COA and its authorized agents to use my name, photographs, and voice recordings in connection with any publicity, training material, television production, internet, including company intranet and world-wide web exposure, or any other record of this event for any EBR COA purpose. I further understand that no special compensation will be provided to me for use of my image and that I may not be informed of the specific use of my image.
Your Name
Date (MM/DD/YYYY)
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