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Volunteers in Motion

Information & Application

Volunteers in Motion Since its inception, Volunteers in Motion has been able to assist thousands of frail and elderly individuals, who would otherwise be unable to live independently. Program volunteers receive training by attending instructional classes, and are provided with state-of-the-art vehicles. Currently, 24 volunteers serve 275 clients, donating over 5,400 hours per year.

Unfortunately, the demand for services is higher than the current number of volunteers can support. Those interested in volunteering can either contact Lori Hamilton, the Volunteers In Motion Supervisor, at 321-635-7999 or fill out the form below to get the ball rolling!

Items marked with an * are required fields.

* Name:
* Mr., Mrs., Ms.:
* Home Address:
* City:
* Zip Code:
* Phone Number:
* E-Mail Address:
* Birth Date (mo/year):

Emergency Contact

Person:
Relationship:
Phone:
Work or Home Number:

Interest

I am interested in the following volunteer position(s):
I am available on the following day(s) of the week:
I have had previous volunteer experience:
I volunteered at:

References
Please list three verifiable references that are not relatives.

Name #1:
Phone:
Name #2:
Phone:
Name #3:
Phone:

I understand that Brevard County requires a review of my driving record and other safety sensitive information. Upon receipt of my application, the volunteers in motion coordinator will contact me to provide additional background information.

Name:
Date:

Under Florida law, e-mail addresses are public records. If you do not want your e-mail address released in response to a public records request, do not send electronic mail to this entity. Instead, contact this office by phone or in writing or call 321-633-1878, Monday – Friday, 8AM to 5PM.

   









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06-26-2017 15:43:41