Pasadena Village Volunteer Application
Pasadena Village is committed to helping older adults support each other as they age in place. Dedicated volunteers, both members of the Village and those from the wider community help members in myriad ways.

We are so grateful for your interest in volunteering with Pasadena Village. Please fill out this form.

All "Home Helper" volunteers and those who drive on behalf of the Village require a background check. Volunteer drivers must also provide proof of their current driver’s license and insurance. If you would like to be a Home Helper or Driver, the Village Office will send you a screening form in addition to this application.

If you have any questions, please contact the Village Office at 626-765-6037 or info@pasadenavillage.org
Sign in to Google to save your progress. Learn more
First & Last Name *
Nickname/preferred name
Mailing address with city, state, zip
Preferred phone number(s)
Email address
Person to notify in case of an emergency. Full Name:
Relationship to Emergency Contact
Emergency Contact's preferred phone number(s)
How did you hear about volunteering with Pasadena Village? 
I acknowledge that I have received Pasadena Village's Privacy & Confidentiality Policy.
Pasadena Village has many events and activities, and we like to share photographs and videos from these events. We use photographs in our publications (including our website), publicity, and promotions. If you would not like Pasadena Village to use your photograph and/or likeness in our publications, publicity, and promotions, please make that known at the events where photographers are present. Pasadena Village's intended use of your likeness will not violate the rights of any person or organization and will not incur any liability payment to any person or organization.
I would like to be a "Home Helper" volunteer and/or a volunteer driver. I understand I must provide a copy of my current driver’s license, proof of insurance, and complete a background check before performing services in a member's home or providing rides. A separate screening form in addition to this application will be sent to you.
Are you interested in online opportunities? 
We look forward to having you volunteer with Pasadena Village! Thank you for your willingness. Please add any comments here or contact the Village Office.
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Pasadena Village. Report Abuse
Google Forms