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Older Adults and Adults with Disabilities - Shelter Volunteer Form
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First Name
*
Your answer
Last Name
*
Your answer
Email
*
Your answer
Phone Number
*
Your answer
Do you have experience working with older adults?
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Yes
No
If yes, please elaborate on your experience working with older adults.
Your answer
Do you have experience working with adults with disabilities?
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Yes
No
If yes, please explain.
Your answer
Do you have any limitations or reservations about working with older adults or adults with disabilities?
*
Yes
No
If yes, please explain.
Your answer
Are you fluent in a language other than English?
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Yes
No
If yes, please specify which languages you are fluent in.
Your answer
Are you willing to complete a background check using LIVESCAN to be a shelter volunteer? LIVESCAN involves providing a government form of identification and electronic fingerprinting. COAD will cover the cost for the LIVESCAN performed locally.
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Yes
No
Are you interested in being a Team Leader?
*
Yes
No
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