COVID-19 shortened SCES Volunteer Application

Volunteer Application

A red asterisk (*) denotes required fields. Questions? Email vol@eldercare.org
Update from SCES as of March 24th, 2020:

Thank you so much for reaching out!

The response that we have gotten from community members is amazing – and we can't tell you how much we appreciate your offer to help. At this point in time, we have more than enough volunteers to help us, but other local groups would benefit from your help. Please visit the Cambridge Volunteer Clearinghouse website or the Mutual Aid for Medford and Somerville group to learn about local opportunities.
Name *

Prefix First Name Last Name

Address *

Best Phone Number (please indicate if Home, Mobile, or Work) *
Optional 2nd phone number (please indicate if Home, Mobile, or Work)
Primary Email *

Confirmation Email example@example.com
How did you find us? If through an online search, which website?
Covid-19 Prevention Volunteer Opportunities
Are you able to make regular phone calls to check on an older adult? *

Yes No
Are you able to use your own car for deliveries (e.g. emergency grocery delivery)? *

Yes No
Are you able to lift and carry 15 lbs (e.g. a bag of groceries to leave outside an older adult's door)? *

Yes No

About You
Are you 18 years of age or older?

Yes No
Would you like to indicate your preferred pronouns?
For example: she/her/hers, they/them/theirs, etc.
Do you speak any languages other than English? If yes, which one(s)?
Optional: Name and Contact info for your Emergency Contact Person

Documentation
I am willing to undergo a Criminal Offender Record Investigation (CORI) and a police background check. This is standard for all community-based volunteers; according to MA General Laws Chapter 6 Sec167-178B, we are required to request a CORI of potential volunteers who would meet with clients. This check requires a photo ID and completed CORI form. *

Yes No
Provide a copy of your Photo ID below

Government-issued photo ID (driver’s license, passport, state ID, foreign passport with VISA). Either take a photo or upload a scan below.
Take photo of photo ID
Optional: preview your photo
Alternately, please upload a PDF, PNG, or JPG file of your Photo ID

CORI Form

Required for All Volunteers. If you are unable to upload your completed CORI, please email it to vol@eldercare.org.
The CORI is a required background check standard for all community-based volunteers; according to MA General Laws Chapter 6 Sec167-178B, we are required to request a CORI of potential volunteers who would meet with clients. Please download this form, complete it, and upload your form below.
Click below to submit your CORI form (please send PDF, PNG, or JPG files).

Browse Files

Cancel of

Almost Done!
Please use this area to include any other information which you think might be relevant to this application.
I understand that the sponsoring agency will do a records check on qualified applicants. I consent to the release of all relevant information concerning my ability and fitness to volunteer. I certify that the information given herein is accurate to the best of my knowledge. I understand this information will be held in confidence and not released to another agency. Please sign: *

Clear
Date

Month Day Year
Date
Thank you for applying to volunteer with Somerville-Cambridge Elder Services!

Please select "submit" below to send your application.
Should be Empty:

Now create your own JotForm - It's free! Create your own JotForm

Volunteer Application