Council on Aging of Buncombe County Volunteer Application

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Thank you for applying to the Council on Aging! Please call us at (828) 277-8288 if you have any trouble filling out this form, or to check in on the status of your application. Our Administrative Coordinator will contact you once your application is received.

Email *

Full Name (First, Middle, Last) *

Date of Birth *

YYYY

Mailing Address, City, State, and Zip *

Daytime Phone *

Alternate Phone

Previous Volunteer Experience *

Talents, Special Training, Interests *

Limitations (physical, seasonal, employment, etc. – please be specific) *

Why do you want to volunteer with the Council on Aging? *

Do you speak or have a working knowledge of a language other than English?

Spanish

Russian

French

Other:

How did you hear about our volunteer program?

Please select the volunteer areas which interest you. *

Delivering groceries to seniors once or twice per month

Transporting seniors to appointments or shopping

Assisting with data entry, bulk mailings or special projects

Providing skills-based volunteer support like video editing, graphic design, website content, etc.

Assisting COA with special events, outreach, and/or fundraisers

Assisting seniors with understanding and signing up for Medicare (additional training required)

Assisting people of any age in signing up for Affordable Care Act insurance (additional training required)

Assisting with Front Desk Opportunities

Assist working in the kitchen at a Senior Dining Site

Assist one of our Senior Dining Sites by delivering food for senior meals

Assisting the Volunteer Coordinator with Administrative Tasks

Required

Availability *

Morning

Afternoon

Evening

Not Available

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

For delivery or driving volunteers: do you carry at least 100,000/300,000 in auto liability coverage? *

Yes

Not sure

Please provide any additional information regarding your availability and how frequently you would like to volunteer.

Please provide three references (not related to you) whom we can contact. *

Reference #1 - Name, Relationship to You, Email, Phone

Please provide three references (not related to you) whom we can contact. *

Reference #2 - Name, Relationship to You, Email, Phone

Please provide three references (not related to you) whom we can contact. *

Reference #3 - Name, Relationship to You, Email, Phone

Emergency Contact: Please list the full name, relationship, daytime phone number, and email address of the person we should notify in case of an emergency. *

Certification *

By typing my full name below, I certify that I have completed this application, and that all information is true and accurate to the best of my knowledge. I understand that this application does not constitute a contract and I may need to provide additional information and undergo a criminal background check, depending on which volunteer opportunities I pursue. I also understand there may not be an immediate placement available.

Today's Date *

YYYY

Send me a copy of my responses.

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