RSVP Application
We would love to get a bit of information from you so we can get you plugged in. We want you to be able to use your gifts and talents to make a difference in our city! Don't worry. This is all confidential to our staff!

Thank you for partnering with us to serve southern Indiana!
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Name *
Address *
City *
Zip code *
Phone *
Email *
Birthday *
Previous Occupation *
Do you already volunteer somewhere? If yes, where?
Are you a veteran? *
If you answered yes to the question above, what branch did you serve in and for how many years?
Emergency Information
Emergency contact name *
Relationship to emergency contact *
Emergency contact - Primary phone number *
Emergency contact - Secondary phone number
Driving Information
If you drive an automobile to your volunteer site
Name of your car insurance company? *
Beneficiary Information
As an RSVP Volunteer, you are covered by free personal accident insurance and personal liability insurance while serving as an RSVP Volunteer. In addition, if you must drive to accomplish your volunteer activities, you are covered by excess automobile liability insurance. In order to receive this excess automobile liability insurance you must maintain a valid driver's license and you must keep your car insurance up to date. All RSVP volunteers receive the free personal accident and personal liability insurance regardless of whether they drive or not. The accident and liability insurance policies also have a death benefit. Please indicate your beneficiary in the spaces below.
Beneficiary Name *
Beneficiary Address *
Beneficiary Phone *
Relationship to beneficiary *
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