Individual Volunteer Sign-Up

Individual Volunteer Sign-Up

Thank you for your interest in volunteering with Senior Community Services! Please fill out this form and a Volunteer Coordinator will be in touch with you soon.
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
You must be 16 or older to volunteer on your own. Youth volunteers as young as 7 are welcome when accompanied by an adult.
Are you 16 or older?*

YesNo

References

Individual volunteers may have access to sensitive information about our program participants. Because of this, we conduct reference checks. Provide a minimum of 2 with at least 1 being a professional reference.
Reference 1*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email
example@example.com
Relationship to you*
Reference 2*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email
example@example.com
Relationship to you*
Reference 3 (optional)

First NameLast Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
Relationship to you

Last questions!
How did you hear about us?*
Select one, or hold down "Control" to select more than one.
Other
Some companies have community giving/donation programs that benefit the organizations their employees volunteer for. Does your company have a program like this?

YesNoI'm not sureI'm retired/Not applicable
Should be Empty:

Emergency Contact Information