Volunteer Application
Volunteer and be a light in someone's day!
What people call you *
Your answer
Email *
Your answer
Phone number *
Your answer
Full address: Street, City, State, & Zip
Your answer
The people you will be helping
How did you hear about us?
Now on to business
Volunteers are very important to the work of AGE of Central Texas! Volunteers enhance the lives of the older adults and caregivers that we serve, help our operations to run at their best, and sustain the culture of service and goodwill that AGE has been part of since 1986. Good stuff!
If you are an individual please continue filling out this form.

If you are a group wanting to come and volunteer, please contact Jayden Beatty at (512) 600-9284 or email jbeatty@ageofcentraltx.org to request a group volunteer opportunity. We will contact you to discuss possible projects and dates, but we cannot guarantee that we will be able to accommodate every request. We ask that you give us at least 6 weeks notice of any group volunteering request.

When are you available to start volunteering? *
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AGE's Programs primarily run from Monday to Friday from 7:00am to 5:30pm. Are you available to volunteer during these hours? *
Have you worked with older adults with dementia before? *
If yes to above, please tell me more
Your answer
This is our favorite question. What skills or abilities would you bring to volunteering that would have a positive impact on AGE and our program members? *
Your answer
What kinds of activities will you be comfortable with? (check all that apply) *
Required
Now some legal stuff. It's important,
You're almost done!
Emergency Contact Name (First and last) *
Your answer
Relationship? *
Your answer
Emergency Contact Phone # *
Your answer
Full name of Parent or Legal Guardian for volunteer if they are a minor
Your answer
I, the parent or legal guardian of the volunteer applicant, give my permission for this minor to volunteer with AGE of Central Texas. (thanks for teaching them great values)
Parent/ Legal Guardian Phone #
Your answer
BACKGROUND CHECK AUTHORIZATION:
BACKGROUND CHECK AUTHORIZATION: I hereby give my permission for AGE of Central Texas (hereby referred to as “AGE” or the “Agency”) to obtain information relating to my criminal history record. The criminal history record, as received from the reporting agencies, may include arrest and conviction data as well as plea bargains, deferred adjudications or delinquent conduct committed as a juvenile. I understand that this information may be used, in part, to determine my eligibility for a volunteer position with this organization. I also understand that as long as I remain a volunteer here, the criminal history records check may be repeated at any time. I understand that it is my responsibility to update the AGE staff if any changes occur in my criminal record. I understand that I will have the opportunity to review the criminal history as received by AGE and that a procedure is available for clarifications if I dispute the record as received. I, the undersigned, do, for myself, my heirs, executors and administrators, hereby remise, release and forever discharge and agree to indemnify AGE and each of its officers, directors, employees, and agents and hold them harmless from and again any and all causes of actions, suits, liabilities, costs, debt and sums or money, claims and demands whatsoever, and any and all related attorney’s fees, court costs, and other expenses resulting from the investigation of my background in connection with my application to become a volunteer.
I agree to BACKGROUND CHECK AUTHORIZATION *
Date of Birth, please *
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I promise...almost done...it's worth it.
Legal Name *
Your answer
CONFIDENTIALITY AGREEMENT:
I understand that as a volunteer for AGE of Central Texas (hereby referred to as “AGE” or the “Agency”) I am responsible for maintaining the privacy and confidentiality of the clients and volunteers involved in the Agency. I understand and agree that I will not reveal the identity of any client at the Agency nor will I discuss or reveal any other information I may hear, see, or obtain while involved with the agency and thereafter. I understand that a breach of this agreement could result in the termination of my further participation with AGE.
I agree to the CONFIDENTIALITY AGREEMENT *
RELEASE FROM LIABILITY:
RELEASE FROM LIABILITY: I acknowledge and assume the risk of participation in any and all activities at AGE of Central Texas (hereby referred to as “AGE” or the “Agency”) or any and all locations where AGE activities take place. I acknowledge that I will release AGE, its staff, volunteers, and agents of and from all claims which may hereafter develop or accrue to them on account of injury, loss or damage, which may be suffered by said minor or to any property, because of any matter, thing, condition or negligence, and I hereby assume and accept the full risk and danger of any hurt, injury or damage which may occur by reason of any matter, thing, condition, negligence or any person whatsoever. It is further agreed that I will maintain a policy of insurance covering medical treatment and related costs in the event of an injury to myself as a result of my participation in any activities at AGE as foresaid. I also understand that if I do not have a policy of insurance, that I am still liable for medical treatment and related costs in the event of an injury incurred in activities at AGE. The invalidity of any statement or waiver of rights above, under local, state, or federal law does not invalidate any other statement or waiver of rights above.
I agree to the RELEASE FROM LIABILITY: *
MEDIA RELEASE: can we use your photo?
MEDIA RELEASE: I hereby give AGE of Central Texas, their assigns, licensees and legal representatives the irrevocable right to use my name, picture, photograph, portrait, visual likeness, statement, or voice in all forms and media in all manners, including photo, film, audio and video representations, for non-profit, public purposes, and I hereby waive any right to inspect or approve the finished product that may be created in connection therewith. The undersigned individual agrees not to bring any action or claim against the agency or its successors, licensees and assigns, or to allow others to bring such an action or claim, and releases the agency, its successors, licensees and assigns from any and all such actions or claims which the undersigned may have now or in the future. I have read this release, and am fully familiar with its contents.
I agree to the MEDIA RELEASE: *
The last think to check.....
I understand that this is an application for, and not a commitment or promise of, a volunteer opportunity. I certify that this information is true, correct, and complete to the best of my knowledge, I understand that if I am accepted as a volunteer, any false statements, omissions, or other misrepresentations made by me on this application may result in my immediate dismissal. I also understand that I will be required to read AGE’s Volunteer Handbook prior to assignment.
I agree?!?! *
And today's date *
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YOU'RE DONE! Good job! Now submit and a live person will review and get back to you. Thanks so much!
Please email me, Lauren, at LRobertson@ageofcentraltx.org if you have not heard back in a week.
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