Adopt-A-Pioneer Program Application

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Adopt-a-Pioneer Program - Volunteer Registration Form

Are you looking for an IMPACTFUL way to make a difference this Ramadan? We are looking for volunteers to dedicate service to our community pioneers. To abide by current physical distancing mandates, we will be providing service in the following ways.

Requirements & Commitment
- Must be at least 18 years old
- Provide references for Reference Check
- Participate in a Volunteer Training/Orientation
- Have a positive attitude towards working and interacting with the elderly

Masjid Affiliation *

Atlanta Masjid

Al Muminun

Other:

Email *

First Name *

Last Name *

Gender *

Male

Female

Date of Birth *

Phone Number *

Mailing Address *

City *

State *

Do you have reliable transportation? *

Yes

Do you have automobile insurance? *

Yes

How would you like to help? *

Select areas you would like to volunteer.

Senior Meals of Wheels - Prepare & Deliver meals or seniors

Eid for Seniors - Make a donation towards providing Eid gifts for seniors

Virtual call or check in with senior members of the community

Required

Why are you interested in the Adopt-A-Pioneer program? (Tell us about yourself and why you are interested in volunteering for this project.)

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