2. Please fill out the information fields below. Once your information is received, an RSVP Program Coordinator will contact you with further information about AmeriCorps Seniors RSVP.

   *Please note that you must be age 55 or better to be a RSVP volunteer.

   Fields in red are required.

4. First Name*
5. Last Name*
7. Phone*
8. Phone type

   1. Cell
   2. Landline
9. Email
11. Address
12. County of Residence*

    1. Benton
    2. Sherburne
    3. Stearns
    4. Wright
14. City*
15. State
16. Zip
18. Birthdate*
19. Gender

    1. Male
    2. Female
    3. None-binary
20. How did you hear about RSVP?

    1. Agency/Partner
    2. Mailer/News/Magazine
    3. Promotional Material/Flyer
    4. Other Internet/Website
    5. RSVP Website
    6. RSVP Volunteer (name?)
    7. Walk-in
    8. Other (add in comments)
21. Name of person who referred you to RSVP:
25. Occupation (current/previous)
26. Are you retired now?

    1. Yes
    2. No
27. Why do you want to volunteer?

    1. Build Skills
    2. Community Service
    3. Give Back
    4. Socialization
    5. Use Skills/Experience
    6. Other (add in comments)
29. Other comments to add:
31. Communication Preference

    1. Email
    2. Text
    3. Phone
32. Do you use social media?

    1. Facebook
    2. YouTube
    3. Other Social Media (please provide)
33. Other social media
35. Are you a Veteran?

    1. Yes
    2. No
36. Are you currently serving in the military?

    1. Yes
    2. No
37. Are any of your family members actively serving?

    1. Yes
    2. No

    If yes, please indicate how many

38. How many?

    Enter how many family members are currently serving in the military

40. Ethnicity/Racial Group

    please choose the option that best describes you

    1. American Indian/Alaska Native
    2. Asian
    3. Black or African American
    4. Hispanic or Latino
    5. Native Hawaiian/Pacific Islander
    6. White
    7. One or more race
42. Emergency Contact #1 - Name/Relationship
43. Phone #1
45. Emergency Contact #2 - Name/Relationship
46. Phone #2
48. Beneficiary for Accidental Death Insurance
49. Beneficiary Phone
51. Transportation

    Please select all that apply

    1. Own Car, will supply driver's license & auto ins # at orientation
    2. Walk
    3. Public transportation
52. Other transportation
54. Tell us a bit about your volunteer interests:

    Check what types of volunteer opportunities interest you to give us a place to start.  We will talk discuss your skills and interests in-depth during your enrollment orientation meeting.

    1. Business: go behind-the-scenes with office or technology skills.
    2. Carpentry & Mechanical: build and repair.
    3. Community Events: lead and serve at larger events.
    4. Companionship: connect one-on-one or in small groups.
    5. Creative Skills/Hobbies: to share.
    6. Education: share knowledge with others-small or larger groups.
    7. Food Security: make sure everyone has enough to eat.
    8. Health/Recreation/ Wellness: better health.
    9. Nature/Outdoors: share your time in the great outdoors.
    10. Personal Services: assist individuals with household duties.
    11. Transportation/Delivery: provide rides for people in need.
    12. One Time Activities or Events: preferred over scheduled on-going positions
56. Photo Permissions

    Do you give RSVP permission to use photos/videos taken of you in your volunteer service for public awareness and educational purposes? (This may include social media)

57. Permission choice

    1. Yes
    2. No
    3. Ask before using
61. Please check each box to confirm that you have read and understand the following:*

    1. RSVP and Agency Partners reserve the right to conduct a background check if deemed necessary. Based on the results, I may be precluded from volunteer positions
    2. I volunteer my services through RSVP and I am not an employee of the City of St Cloud (the sponsor of the local RSVP).
    3. If I use my personal vehicle to volunteer, I will need to maintain a valid Driver’s License and automobile liability insurance as required by State law.
    4. I authorize the City of St Cloud to release the private data about me contained on the RSVP enrollment form and skills bank form to RSVP, granting agencies, funding sources, and referral partners.
63. Enter your full name as an electronic signature*
65. One of our RSVP Program Coordinators will be in touch with you shortly to review your application. After approval, you will be scheduled for a brief orientation to introduce you to the opportunities available to volunteers through AmeriCorps Seniors RSVP.
67. THANK YOU for your interest in volunteering with RSVP!
Leave This Blank:


69. 1. Receive an email copy of this form.
70. Email address

    This field is not part of the form submission.

71. Submit

* indicates a required field