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Eisner Prize Winner

Program of Distinction

UJA-New York


Package Delivery Feedback Form 2019

  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 us to his or her current needs.

  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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Question - Required - Location



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Question - Required - I/We volunteered as a/an:



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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 many volunteer opportunities to help address social isolation among our seniors. Are you interested in continuing to volunteer with DOROT?

 

 
 

Thank you for your comments and participation!


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