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Volunteer Driver Application

Please fill out the following form completely and send it using the Submit button below.  The fields marked with an asterisk (*) are required.  We will process your application shortly and call you back soon.

Personal Information






















Emergency Contact





Personal Character Reference








Days/Times Available

Please enter your availability in the boxes below for the days of the week you would be interested in driving. If there are certain time periods in which you wish to volunteer, please note those as well. We are extremely flexible. You drive as little or as often as you like, choosing the days, times and areas that work for you. Please remember, you are not committed to the days and times you indicate below. As your schedule changes you may change your availability, even from one week to the next! And if you are not available to drive for a week, or several weeks, or a month, or even several months, just let us know.


*What days and times are you available? MorningAfternoonAll Day
Monday
Tuesday
Wednesday
Thursday
Friday


Please note that most rides take three to four hours of your time.


Service Area




Driving Record

PLEASE NOTE:  A MANDATE FROM ONE OF OUR FUNDING SOURCES STATES THAT NEW VOLUNTEERS CANNOT HAVE ANY DRIVING CITATIONS ON THEIR THREE-YEAR DRIVING ABSTRACT, including speeding tickets.









  • eluding a police vehicle
  • reckless (negligent) driving
  • vehicular assault/homicide
  • hit & run felony
  • more than one accident in a 3 year period
  • driving while intoxicated or under the influence of drugs







Vehicle Information




License Information






Insurance Information

*Volunteer drivers must have minimum state insurance coverage per Code of WA (46.29.090): $25,000 of bodily injury or death of 1 person in any 1 accident; $50,000 of bodily injury or death of any 2 people in any 1 accident; and $10,000 of injury to or destruction of property of others in any 1 accident.








refused, cancelled, non-renewed or given notice of intention to non-renew automobile insurance to you? If yes, please explain

Senior Services provides excess liability insurance coverage at no cost to you when you are doing assigned volunteer work. This coverage includes $1,000,000 of Auto Liability insurance and $5,000,000 in umbrella liability insurance. Complete information describing the coverage will be included in your orientation materials.

Once you hit the Submit button, your application will be sent to our Volunteer Recruiter who will contact you to further discuss this opportunity. 

If you hit the Submit button without filling out all fields marked with an asterisk, you will be directed back to the beginning of the application.  Please complete all required fields and re-submit your application.