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DOROT Westchester

 



Package Delivery Feedback Form - Thanksgiving 2014

  Thank you for volunteering to deliver a package and visit with a senior. We hope this was a meaningful experience for you. Please fill out the form below including any pertinent information about the person you visited. Your comments alert DOROT to the current needs of this person.

  If you have any questions, please do not hesitate to contact us. We appreciate your help!

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Name:

 

 

   

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City/State/ZIP:

 

    

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What's this?

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(Maximum response 255 chars, approx. 5 rows of text)

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Question - Required - Overall, how would you rate the visit?




 

 

 

 


 


 

(Maximum response 255 chars, approx. 5 rows of text)

 
Question - Not Required - DOROT has a growing waiting list of seniors who are eager to be matched to a volunteer for weekly visits. Would you like to explore being a companion to an older person?

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Question - Required - Please rate how well the program was organized:




 

(Maximum response 255 chars, approx. 5 rows of text)

 


 

 


  I am interested in the following Occasional Adult Volunteer Opportunities.
 
Question - Not Required - Please contact me about:

 

 

Thank you for your comments and participation!


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