• Volunteer Application Instructions

  • Thank you for your interest in becoming a new volunteer with the Central Vermont
    Council on Aging (CVCOA)! We look forward to working with you to find the best
    opportunity to fit your needs, schedule, interests, and goals.


    Please complete the following steps for your application. If you are unable to fill the
    application digitally, we can send you a copy in the mail.


    Step 1: Complete the Volunteer Application.


    Step 2: Complete the Background Check Authorization Form. Please note that we only ask for the last 4 digits of your SSN.


    Step 3: Complete the CVCOA/RSVP Signature Page.


    Step 4: Select Submit.

     
    Please note that it may take us up to two weeks to process your application. We will be in contact with you about any additional materials needed to complete your application. Once your application has been processed, we will send our handbook and the training materials that are relevant to your volunteer activity. Feel free to reach out at any point if you have questions about the application process or volunteer activity.


    Thanks for your service!

  • VOLUNTEER APPLICATION FORM

    CONTACT INFORMATION/ABOUT YOU
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Are you a Veteran?
  • VOLUNTEER INTERESTS: Please check all that apply. Please note that meal prep and delivering Meals on Wheels happens on weekday mornings and office work happens during the week.

  • Availability

  • Seasonal Resident?
  • Do you own a car?
  • How did you hear about us? Please check all that apply.

  • EXPERIENCE/INTERESTS/BACKGROUND

  • Confidential Background Check Authorization

  • Date of Birth:*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Driver's License Expiration Date:
     - -
    2 digit month, 2 digit day, 4 digit year

  • I attest that the information contained in this application is correct to the best of my knowledge.
    I hereby authorize CVCOA and its designated agents and representatives to conduct a comprehensive review of my background causing a report to be generated for volunteer purposes.
    I understand that the scope of the report may include, but is not limited to the following areas:

    • Vermont Adult Abuse Registry
    • Vermont Child Protection Registry
    • Vermont Criminal Convictions Records
    • Vermont Department of Motor Vehicles Records or last state of residence
    • Office of Inspector General Exclusions Database
    • National Sex Offender Public Website


    CVCOA and its representatives shall maintain all information received from this authorization in a confidential manner in order to protect the applicant’s personal information, including, but not limited to, addresses, social security numbers, and dates of birth.

  • Today's Date:*
     - -
    2 digit month, 2 digit day, 4 digit year

  • SIGNATURE PAGE

  • BENEFICIARY for CVCOA/RSVP Supplemental Accident Insurance (someone other than yourself)

  • EMERGENCY CONTACT

  • Format: (000) 000-0000.

  • AGREEMENTS AND AUTHORIZATIONS Initial below each paragraph and sign at the end

  • AUTO INSURANCE AGREEMENT

    1. I understand that if I use my personal automobile driving to or on assignment with CVCOA/RSVP of Central Vermont, I will keep in effect my own automobile insurance equal to the minnimum amount required by the State of Vermont ($50,000 bodily injury; $50,000 property damage.)

    2. I agree to keep my driver's license current and to notify CVCOA/RSVP with any loss of coverage or licensure.

  • CONFIDENTIALITY AGREEMENT

    1. It is important that CVCOA/RSVP volunteers respect the privacy of the stations they serve and the clients they work with. While serving, volunteers often learn a great deal of information that should not be shared with others. This includes, but is not limited to: anything about the client's health or living situation; names and other identifying information about individuals; financial details of an organization or individual; or client's attitudes, background or personal information.

    2. I recognize my position as a CVCOA/RSVP volunteer requires considerable responsibility and trust. I understand that I may be entrusted with sensitive, confidential, restricted and proprietary information in the course of my volunteer work.

    3. I agree not to use or disclose any confidential information which is disclosed to me as a result of my serving as a CVOCA/RSVP volunteer except as is required to perform my duties. An exception to this occurs when I believe that an individual's life may be in danger. In this case, I would report to my CVCOA/RSVP or station supervisor. In case of an emergency, I would contact 9-1-1.

  • VOLUNTEER AGREEMENT

    1. I understand I am a volunteer; I am not an employee of Central Vermont Council on Aging (CVOCA)/RSVP or the volunteer station to which I have been assigned. I have been informed of the benefits and policies of CVCOA/RSVP of Central Vermont.

    2. I understand that it is my responsibility as a CVCOA/RSVP volunteer to notify staff at the Central Vermont Council on Aging/RSVP in case of difficultities, emergencies, or other challenges related to volunteer assignment.

  • Photo Release

    I agree that CVCOA/RSVP may use photos of me taken while serving as a volunteer in various media for outreach or educational purposes.

  • Today's Date:*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Today's Date:
     - -
    2 digit month, 2 digit day, 4 digit year
  • Should be Empty: