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Volunteer Enrollment Form

Personal Information
Marital Status:
Single
Married
Widowed
Ethnic Group:
Caucasian
African-American
Hispanic
Native American
Asian
Other
Are you a veteran of US armed forces?
Emergency Contact Information
Please indicate a person to contact if there is an emergency on a volunteer site.
Beneficiary For RSVP Supplemental Accident Insurance
For RSVP volunteers ONLY (age 55 and up).
Volunteer Interests

Check all that interest you

Adult Literacy / Teach Computer Skills
Clerical Work
Food Pantries
Gardening/Plants/Flowers
Helping with Medicare Fraud Awareness
Military Family Assistance
Habitat for Humanity
Hospice Care
Income Tax Preparation
Local Emergencies
Hope Landing
Neighborhood Watch
Nursing Home visitations
Special Mailings
Salvation Army
Phone Pals
Recycling
Crafts/Crocheting/Knitting/Quilting
Transportation for frail elders
Deliver meals to homebound
Yard Work/Home Repairs
Community & Special Events
By checking the box, I certify that the above information is true and correct.
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