Volunteer Application for White Bear Area Senior Program
2484 East County Road F
White Bear Lake, MN 55110
Name (First, Last)
Best phone number to reach you
Where did you hear about the Senior Volunteer Program?
Why are you interested in volunteering for our program?
Previous volunteer or work experience?
Do you have any limitation that might limit your volunteering?
If you answered YES to the above question, please explain.
Areas of Volunteer Service
Please indicate the areas you are interested in.
Senior Center Opportunities
Sr Center: Craft Corner Gift Shop
Sr Center: Clean Crew
Sr Center: Foot Care Cinic
Sr Center: Office Assistant
Sr Center: Senior Companions
Meals on Wheels: Route Driver
Meals on Wheels: Kitchen Aid
School: Elementary School Volunteer
What mornings are you available to volunteer?
What afternoons are you available?
Time available to volunteer
Special or One Time Projects
Reference #1 - Name and phone number
Reference #2 - Name and phone number
Emergency Contact - Name and phone number
Matching Gift Program: Does your company participate in a Matching Gift Program for volunteer work?
The above information is correct to the best of my knowledge. I understand that this form is confidential and its contents will not be released to anyone without my written consent, with the exception that references will be made aware of my volunteer position application. I agree to notify the White Bear Area Senior Program of any changes in the above information.
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