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Independent Living Program Volunteer Interest Form

Independent Living Program Volunteer Interest Form

Thank you for your interest in volunteering with the Senior Companions Program, part of the City of Jacksonville's Independent Living Program. Please complete the form below fully, and a staff member will reach out to you to discuss volunteering in further detail! 


Please include your first and last name...
     
     
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Gender:

     
Veteran:

     
Bilingual:

     
Special Accommodation Needed?:

     
Transport:


     
Availability (Select All That Apply):






     
Volunteer Area (Select Any):



     
Are you able to work 15 hours/week?: