VOLUNTEERSThe Heart & Soul of Our Organization

“I VOLUNTEER because of the great satisfaction I get in helping others.”

- Council for Older Adults volunteer

Please list two references, other than relatives, whom we may contact:

Name Phone Number

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!

Get InvolvedWe 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

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 HeartBy 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 TimeEach 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 TalentOur 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.

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.

Council for Older Adults

One call. Multiple services.

(740) 363-6677www.growingolder.org

Volunteer ApplicationCouncil for Older Adults800 Cheshire Road, Delaware, Ohio 43015(740) 363-6677 | 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 Once or twice a month One time only

Which days do you prefer to volunteer? Sunday Monday Tuesday Wednesday

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 If yes, when?

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? Where?

How did you hear about COA?

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 No

Do you have your own reliable transportation? Yes No

Current driver's license? Yes No