Application to Volunteer

Application to Volunteer

Share your time and skill with residents at Thurston Woods Village!
The safety of our residents is our number one priority. We personally interview each potential volunteer to make sure they are eligible to work with seniors and are a good fit for the community. The first step is completing this application. After your application is reviewed, our Activities Director, Robyn Roop, will follow up with you. Thank you for your willingness to share your time and gifts with us. We look forward to seeing you at Thurston Woods!
Date*

MonthDayYear
Date
Are you volunteering as an individual or part of a group?*

IndividualGroup
Group/Organization Name
Are you under 18 years of age?

YesNo
Are there any volunteers in your group under the age of 18?

YesNo

Contact Information
Applicant Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Availability
How often would you like to volunteer?*

DailyWeeklyWeekendsOther

Which days and times are you available to volunteer?*

	Mornings	Afternoons	Evenings
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

How many hours will you give per visit?*
In which areas of our community are you interested in volunteering?*

Independent LivingAssisted LivingNursing HomeUnsure
Do you know someone living at Thurston Woods?*

YesNo
Resident's Name

Safety Pledge
I, {applicantName} , pledge to support, protect, and serve residents living at Thurston Woods Village, Inc., and will advocate for the rights, health, safety, and dignity of the people I interact with at Thurston Woods. Please initial below indicating your agreement with and understanding of each of the following statements:

Residents have the right to:
Initials* privacy,
Initials* confidentiality,
Initials* refuse to participate, and
Initials*  freedom from abuse.

Initials*   I will not attend my volunteer shift if I feel ill.

Initials*  I will abide by CDC requirements for hand washing and infection control procedures, including required COVID testing.

Initials*  I will not bring cookies, cake, or other treats or distribute them to residents without obtaining permission.

Initials*   I will not smoke on Thurston Woods Village's property.

Initials*   I agree to provide Thurston Woods Village with a copy of my COVID-19 vaccination record.

I further understand that Thurston Woods Village, Inc., will, at their expense, administer the following:

Initials*   I agree to get a Tuberculosis (TB) test prior to starting.

Initials*  I agree to have my fingerprints taken and a background check performed.

Sign and Date
Applicant's Signature*

Clear
Date*

MonthDayYear
Date
Responsible Party's Name (if applicant is under 18)

First NameLast Name
Signature of Responsible Party (if applicant is under 18)

Clear
Date

MonthDayYear
Date
Should be Empty: