Please Complete Our Electronic Volunteer Senior Services Application

About You

Your Name (First, Middle and Last Names are required):  

Birthdate: 

Your Address: 

Your Phone Numbers: 

Your Email Address: 

Do you have any health conditions we should know about: 

In case of Emergency contact:

Your Employment/Volunteer Experience:

Your Education/Training: 

Your Skills Hobbies: 

We have a number of volunteer opportunities please tell us which of these interest you:
Barista/Coffee Bar, Board Member, Boutique, Instructor,
Nutrition (Kitchen/dining crew, Meals on Wheels, Dishwasher), Receptionist,
Trips & Travel, Transportation

Your Selection(s):   

Please indicate the days and times (AM or PM) when you would like to volunteer,  Monday through Saturday: 

Days and time:  

By your Electronic Signature below you agree that we can conduct a criminal history background check by the Washington State Patrol:

Type in Your Signature and Date:

Your 3 References and their Phone Numbers:  

Code of Conduct

1. Treat all Participants, paid or volunteer staff with respect and empathy.
2. Treat Equipment with respect by proper use and care.
3. Respect the rules of access to space and/or equipment.
4. Use appropriate language; no foul language, innuendoes or gestures will be tolerated.
5. Be responsible for yourself and your personal belongings.
6. Be understanding of others' feelings. Abstain from, arguing, violent behavior or threats.
7. If there is a "situation", get your supervisor or other paid staff person to intervene.

Type in your Signature and today's date: 

Questions about this application email Our Volunteer Office or call 360.586.6181