Include your last name.

Required to run a background check.

Helps us obtain background check results in a timely fashion.

You must be at least 18 years of age.

If yes, please include an explanation. A charge/conviction does not necessarily bar you from volunteering.

I verify that all of the information above is correct and true to the best of my knowledge. I am interested in volunteering at Area 10. I understand that all information is kept strictly confidential. I give Area 10 the right to investigate all references. I hereby release the use of my photograph, and understand that the photograph may be used for a variety of purposes, including, but not limited to, newspapers, websites, brochures, and newsletters. I release RSVP and Area 10 Agency on Aging from any claim which may arise from participation in RSVP or Area 10 activities. My signature also verifies my permission to run a criminal background check and to share this information with any agencies with which I volunteer. I agree to notify Area 10 immediately if anything changes that would affect the results of my background check.

To help ensure that we assist our clients in the best possible manner, and for our own well-being, we adhere to the following code of conduct:• We maintain professional boundaries. We do not bring personal issues to the clients.• We uphold the confidentiality of names, addresses, and phone numbers of the clients. • No information obtained at the site will be taken outside of the site, with the exception of notifying Area 10 or APS when necessary.• We refrain from handling or dispensing any medications to the clients (verbal reminders are okay).• We call for help if a client falls or has any other medical issue, following the guidelines set forth in the volunteer handbook.• We refrain from transporting clients in our personal vehicles. • We agree to report hours via a sign-in sheet or directly to volunteer coordinator.

Volunteers, interns and work-study students of the Area 10 Agency on Aging are expected to:• Work according to the duties in their job description• Treat Area 10 consumers, contractors, community and business associates, and the public with respect• Not discriminate against any person on the basis of race, religion, color, national  origin, including individuals with limited English proficiency, sex, age, political affiliation, marital status, sexual orientation, income, or disability• Understand smoking in the facility is prohibited• Be sensitive to the fact that others in the office are working.  Loud, boisterous noises should be avoided during office hours• Not request sexual favors, offer unwelcome or unsolicited sexual advances or other verbal or physical conduct of a sexual nature• Not create an intimidating, hostile or offensive working environment• Understand my work with the agency may be suspended or terminated for cause. Grounds for removal include but are not limited to: extensive and unauthorized absences, misconduct, inability to perform assignments, and failure to accept supervision• Understand my rights and my option to file a complaint or grievance and appeal any disciplinary action taken against me first to the program supervisor, then to the Executive Director• Understand I have an advocate, the agency’s executive director, to assist me with resolving conflicts or any problems that may occur