Care Team Volunteer Registration Form

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Care Team Volunteer Registration Form

How are you able to serve?

___	Provide transportation* to ____ Tuesday meditation group ____ Saturday day-longs ____ Other dharma events ____ Health care appointments, shopping, or miscellaneous needs *Must have current automobile insurance and driver’s license.
___	Prepare in home or bring meals
___	Provide companionship
___	Provide light housekeeping
___	Accompany individuals on walks
___	Get groceries
___	Take care of pets, walk dog
___	Provide emergency babysitting/elder care
___	Provide phone contact
___	Provide chaplaincy services
___	Serve on Care Committee
___	Other (please explain below)

Name:

Address:

Phone number:

Email Address: (Please print mindfully).

Do you wish to be added to the IMSB general email list (circle one)? Yes No

Please give the completed form to a Care Committee member or fold and place it in the Metta Box located on the flyer table at regular sittings.
Thank you.