top of page

For Office Use Only

Check when Completed:

Transportation Program - Driver Application
Have you ever been convicted of a crime?

As a Volunteer Driver...

I would like to provide transportation as a: (check all that apply)
TRANSPORTATION: I would like to provide occasional rides: (check all that apply)
GROCERY DELIVERY: I would like to provide pick up and delivery services:
GROCERY DELIVERY: I would like to provide pick up and delivery services:

I will be providing rides in the vehicle(s) listed below:

Primary Vehicle

Secondary Vehicle

RSVP volunteers are eligible to be reimbursed for mileage expenses incurred while volunteering. 

Ask how you can request this benefit.

Emergency Contact

Consent and Signature

Thank you! We'll be in touch.

bottom of page