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Nassau County District 16 Neighbors Helping Neighbors: Community Volunteer Sign-Up Form
A Community Outreach Initiative in Partnership with the Mid Island Y JCC - Sign Up Today!
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Name - Enter First Name and Last Name
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Your answer
Address - Enter Street Address
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Your answer
Address - Enter City (Example: "Plainview," "Jericho")
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Your answer
Address - Enter Zip Code
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Your answer
Cell Phone Number
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Your answer
Email Address
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Your answer
Can you spare 30 mins to an hour of your time to help make calls and check on you neighbors?
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Yes
No
Do you have access to a vehicle, and if so, would you be comfortable using your vehicle to help your neighbors? (Example: picking up groceries for an elderly neighbor)
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Yes!
No, but I can help in other ways - just tell me how!
Thank You for Becoming a District 16 Community Volunteer!
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