VOLUNTEERS
Please list two references, other than relatives, whom we may contact: Name Phone Number
The Heart & Soul of Our Organization
Address Relationship Name Phone Number Address Relationship Please check the volunteer opportunities that interest you: Catering
Farmers' Markets
Meals On Wheels
Commodities
Home Chores
Office Assistant
Deliveries (Medical Supplies)
Kitchen Assistant
Special Events
Dining Room Assistant
Mailings
Transportation
Enrichment Center
Marketing/PR
Other:
Equal Employment Opportunity Opportunities for volunteers are provided without regard to race, color, religion, sex, national origin, veteran status of disability. I attest that all the information furnished in this application is true, accurate and complete to the best of my knowledge. I understand that if given the opportunity to volunteer, any misstatement or omission of fact on this application is cause for immediate dismissal. I authorize the Council for Older Adults (COA) to verify any information I have provided by contacting references and other appropriate sources. I release reference sources from all liability or damages on account of furnishing information regarding my personal character, habits, performance, or disciplinary records. I further understand that if accepted as a volunteer at COA, my volunteer service will be at will, and that service at COA may be terminated with or without cause, and without notice, at any time, at the option of either COA or myself. I understand that background checks and/or fingerprints may be required as a condition of volunteering at COA to protect clients, team members, volunteer and paid staff. Signature Date Guardian (if under 18) Date
Thank you for your interest in becoming a volunteer for the Council for Older Adults!
“I VOLUNTEER because of the great satisfaction I get in helping others.� - Council for Older Adults volunteer
The Council for Older Adults was founded by volunteers, and they continue to remain a vital key to our success. We depend on the energy and skills of our volunteers to fulfill our mission and to serve the public. We welcome one and all to get involved, whether for just one day, or for an ongoing experience.
Share Your Heart By volunteering at the Council, you’ll not only make new friends and share a feeling of camaraderie with staff and fellow volunteers, but you’ll make a difference in the lives of older adults in your community.
Share Your Time Each year, our dedicated volunteers donate over 50,000 hours of their time at a value approaching $1 million. Without your priceless contributions, our organization would not be successful.
Share Your Talent Our volunteers enjoy their service and find that it provides many benefits, including the opportunity to give back to their own community. The Council builds upon your skills to deliver quality services to the older population of Delaware County.
Volunteer Application Council for Older Adults 800 Cheshire Road, Delaware, Ohio 43015 (740) 363-6677 | www.growingolder.org
Get Involved We offer a variety of volunteer opportunities, including the chance to: • Deliver hot meals to older adults as a Meals On Wheels driver or assistant • Transport seniors to medical appointments as a transportation volunteer • Lend a hand in the kitchen or dining center as part of our nutrition department • Distribute vouchers, literature and displays to local businesses and farmers’ markets • Help with mailings and other clerical work • Help seniors with home chores, such as leaf raking or painting • Assist at catered events to help raise funds for our senior services programs • Staff health fairs and special events
Join Our Team! There are five easy ways to sign up: • Call the Council office at (740) 363-6677 • Mail your completed application to the Council for Older Adults, Attn: Volunteer Dept., 800 Cheshire Rd., Delaware, OH 43015 • Fax your application to (740) 363-7588 • Email fryer@growingolder.org • Apply online at www.growingolder.org
First Name M.I. Last Name Age Under 21 21-59 60-84 85+ Gender Male Female Address City County State Zip Home Phone Cell Phone Email Address What time of day are you interested in volunteering?
Morning
Afternoon
Evening
What length of time are you interested in volunteering?
0-6 months
6-12 months
1 year+
I prefer a volunteer commitment
Once a week
Which days do you prefer to volunteer?
Sunday
Once or twice a month
One time only
Monday
Wednesday
Tuesday
Thursday Friday Saturday Other volunteer programs or organizations you are currently involved in:
Education, qualifications, special skills, languages spoken, etc.:
Do you travel or live out of state on a regular basis?
Yes
No
Are you a provider of COA or an employee of a provider?
Yes
No
Have you ever volunteered for COA before?
Yes
No
If yes, when?
If yes, when? Where? The Council for Older Adults is a nonprofit 501(c)(3) organization that helps older people in Delaware County live safely in their own homes and stay healthy as they age. Programs and services provided by the Council are supported in part by the local senior services levy, corporate and private donations, and grants. The Council for Older Adults is a United Way agency.
How did you hear about COA?
Council for Older Adults
One call. Multiple services. (740) 363-6677 www.growingolder.org
Are there any special circumstances that we need to be aware of when matching you with a volunteer opportunity? Yes
No
If yes, explain:
Have you ever been charged with or convicted of a crime?
Yes
Do you have your own reliable transportation?
No
Current driver's license?
Yes
No
Yes
No