GESMV | volunteer application

Interested in becoming a volunteer with Goodwill Easterseals Miami Valley?

Ask about attending one of our upcoming volunteer orientations to learn more about volunteer opportunities at Goodwill Easterseals Miami Valley.

Reach us by phone

Name ( First and Last):

Phone:

Email:

Which city are you closer to DAYTON or LIMA:

Best Time of Day to Contact::



Please select the medical equipment you are requesting.

Mobility Assistance
Wheelchair with Elevated Leg Rests
Wheelchair with Standard Foot Rests
Transport Wheelchair
Quad Cane
Single Point Cane
Crutches
Forearm Crutches
Deluxe Walker (4 wheels with feet)
Standard Walker (with or without wheels)

Toilet Assistance
Toilet Rails
Elevated Toilet Seat
Commode
Over the Toilet/Bedside

Tub and Shower Assistance
Tub Seat
Tub Stool
Transfer Bench

Daily Living Assistance
Shoe Horn
Sock Aids
Reacher
Bed Rails/Tub Rails