If you would like to volunteer, as a driver, organizer, board member or anything else, please fill out and submit the form below and a friendly member of our staff will get in touch with you shortly.

Personal Information

Prefer Home# or Cell#?

Please check any volunteer option(s) that may interest you.

I can volunteer with the following parameters:
How do you prefer to be assigned to drives? Please select ONE:

Answer the next 3 questions if you plan to volunteer as a driver:

What type of car do you drive?
Will anyone else be with you in the car?
We serve people who live in Northwest Austin, Cedar Park, and Leander. Do you have any limitations on the distance you would drive for volunteer work?

Emergency Contact

References (Please list two).

I confirm that all of the above information is true and correct to the best of my knowledge. I give my consent for Drive a Senior Northwest to contact my references. I understand that a criminal background check ( and for volunteer drivers - a driving record check ) will be conducted. If volunteering to drive, I agree that I am responsible for maintaining a valid driver's license & current liability insurance on my vehicle and am obligated to notify Drive a Senior Northwest of change in status of either.