COVID-19 Volunteer Form

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What Can You Do to Help? Want to Volunteer? Iowa County Emergency Operations Center is looking for volunteers to help during the COVID-19 pandemic. We would like to start a list of individual volunteers who would like to help with delivery of Meals on Wheels, curb-side pickup of SUN meals, grocery deliveries, and other assistance as needed. Please fill out the attached form to be considered. All applicants will have a background check done. If you have questions, please email adrc@iowacounty.org or call (608) 930-9835.

*First Name

*Middle Name

*Last Name

*Date of Birth

*Email Address

*Cell Phone

*Driver's License (number, state of issue, expiration date)

*Address

*City

*State/Province

*Zip Code

*Please list all volunteer items you are able to help with: * Deliver meals for Meals on Wheels *Assist at the dining site for curb-side pickup *Grocery / Medicine Delivery *Willing to call a shut-in resident who feels isolated *Other - as needs arise

*Please list area of Iowa County willing to serve: (Ex. Specific community or anywhere in the County)

*Please list availability: (Days, time of day, amount of time)