Freeport Grocery Buddy Volunteer form

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Thank you for your interest in volunteering to help our community! Please complete the following information and we will be in touch.

Email *

First Name *

Last Name *

Home Address *

Date of birth *

YYYY

Cell phone number *

Home phone number *

Driver's license number (Freeport Police Dept. will be running a check) *

Car make *

Car model *

Car color *

Please provide one Freeport resident reference (Name, Address, Phone, Email) *

By checking below I agree to follow the “How to make safe deliveries for a vulnerable community member during Covid-19” guidelines as established by the CDC 3/20.( copy of guidelines will be provided). I understand that I am volunteering to participate in the Freeport Grocery Buddy program, and that participating in this program may increase my exposure to the coronavirus and am doing so at my own risk. My name, car description information, and phone number may be given to the person I am paired with. *

I agree

Feel free to add any other information

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