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Volunteers in Motion Application

Our volunteers enable the Volunteers in Motion program to grow and continue to be a Brevard County Success Story! A few hours of volunteer support once or twice a week makes a major difference in a senior’s life.

Volunteers are needed to fill positions such as Vehicle Operators, Clerks, Attendants, Escorts, Dispatchers and Reservations. If you are interested in finding out more about how you can join these awesome volunteers, please fill out the form or call (321) 635-7999.

Items marked with an * are required fields.		  
* Name:
* Mr., Mrs., Ms.:
* Home Address:
* City:
* Zip Code:
* Phone Number:
* E-Mail Address:
* Birth Date (mo/year):
Emergency Contact
Person:
Relationship:
Phone:
Work or Home Number:
Interest
I am interested in the following volunteer position(s):
I am available on the following day(s) of the week:
I have had previous volunteer experience: Yes
No
I volunteered at:
References
Please list three verifiable references that are not relatives
Name #1:
Phone:
Name #2:
Phone:
Name #3:
Phone:
I understand that State requirements of the Volunteers in Motion program include a review of my driving record and other safety sensitive information. Upon receipt of my application, I will be contacted by the Volunteers in Motion Coordinator to provide additional background information.
Name
Date
Under Florida law, e-mail addresses are public records. If you do not want your e-mail address
released in response to a public records request, do not send electronic mail to this entity.
Instead, contact this office by phone or in writing or call 321-633-1878, Monday - Friday, 8AM to 5PM.
   

No fixed route bus service on Labor Day, Monday, September 6th. For more information please contact 633-1878.
Contact Options
Customer Feedback
Compliments & Concerns
Citizen Participation
Customer Service 321-633-1878 Public Documents