Volunteer Registration Form | Cornwall Manor

* = Required fields

Name *

E-mail Address *

Address *

City *

State *

Zip *

Phone *

What area of volunteering are you interested in?*

Are you representing a church group or other organization? YesNo

Are you 19 or older? * YesNo

What days and times are you available to volunteer?

Why do you want to volunteer at Cornwall Manor?

Is there anything physically that would prevent you from performing any volunteer function in a reasonable and safe manner?

Do you have any friends or relatives who volunteer, work for or live at Cornwall Manor? If yes, who?
YesNo

Do you have previous experience with seniors? YesNo

Special training/interests/hobbies/
skills/activities?

REFERENCES (Three are required):*

Name *

Address *

City *

State *

Zip *

Phone *

Relationship to You *

Name *

Address *

City *

State *

Zip *

Phone *

Relationship to You *

Name *

Address *

City *

State *

Zip *

Phone *

Relationship to You *

Is fire hot or cold?

LEARN MORE ABOUT THE NEIGHBORHOOD

RESIDENTIAL OPTIONS

LIFE AT CORNWALL MANOR

HEALTH & WELLNESS

FRIENDS & FAMILY

Cornwall Manor is a non-profit active senior living community in Lebanon County, south-central Pennsylvania near Lebanon, Hershey and Lancaster, PA. We offer choices of apartments and homes as well as healthcare services to individuals aged 60 and over.

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