District of Columbia Office on Aging Volunteer Form

First Name

Last Name

Address:

Email Address

Ward

Home Phone

Cell Phone

Have you completed the Ambassador Training Program?

Yes

No

Are you interested in becoming an Ambassador?

Yes

No

Areas of interest(s):

Administrative

Community Outreach

Senior Wellness Center/Lead Agency

Special Events

Youth (Jumpstart’s Literacy Program)

Enter the name of the special event

Availability (please check all that apply): Shifts

Morning

Afternoon

Evening

Weekday

Weekend

Saturday

Sunday

If you have any questions, contact
Krystal Branton, Community Relations Specialist
Phone: (202) 727-8370
Email: [email protected].

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