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Volunteer Application Form

Wicomico at Home, a program of MAC, Inc., relies on volunteers like you!

To become a volunteer with Wicomico at Home, please complete the interest form below. Volunteers must complete a full application and background check prior to beginning service. Please complete this form to express interest, and our team will be in touch soon to discuss next steps.

Your Information

First name

Last name

Phone

Cell phone

Date of birth

Address

Number

Street

City

State

Zip Code

Additional Information

Do you have a current and valid drivers license? Do you have current and valid car insurance?

Mobility issues

How did you hear about us

Additional Comments

I confirm that I have read, consent and agree to Revolutionaging’s (Helpful Village’s) TERMS OF USE and PRIVACY POLICY

Thank you for your interest

Thank you for contacting us — it’s a pleasure to connect! Our team is committed to providing friendly, professional assistance, and we’ll be reviewing your message right away. You’ll hear back from us soon.