Please complete this application form if you are interested in becoming a Senior Connections volunteer with CMSS. Once you complete the form, click the 'Continue' button at the bottom.

If you have any questions or encounter any issues with the application, please contact Alex Scharf (she/her), Volunteer & Intern Services Coordinator, at ascharf@cmsschicago.org or (773) 596-2255.


Name and Contact Information


Demographic Information

Providing the following information is optional. Demographic information is often requested on reports and grant applications. CMSS strives to foster an inclusive and culturally diverse team of volunteers that represents those we serve. 



Volunteering with Senior Connections


Experience with Older Adults


Previous Volunteer and Work Experience


Interests and Skills


Availability


Placement

Please indicate your comfort level with the following at the home of an older adult:



Additional Considerations


Emergency Contact


CMSS Policies

COVID Vaccination Requirements

Prospective CMSS volunteers must be fully vaccinated in order to be considered for placement at any of our communities or programs. Proof of vaccination will be requested upon acceptance into CMSS' volunteer program.

Background Check

Prior to volunteering with CMSS, all individuals must submit to and pass a background check. A copy of a valid photo ID is required.

Driving

CMSS prohibits volunteers from transporting Senior Connections participants and does not offer any liability/accident coverage for Senior Connections volunteers.



Policies Acknowledgement and Agreement

Electronic Agreement & Signature

By submitting this application, I affirm that the facts set forth in it are true and complete. I understand that if I am accepted as a volunteer, any false statements, omissions, or other misrepresentations made on this application may result in my immediate dismissal. 

In addition, I acknowledge and agree to abide by the aforementioned CMSS Vaccination Requirements, Background Check Submission, and Driving Restriction.

Non Discrimination Policy

It is the policy of this organization to provide equal opportunities without regard to race, color, religion, national origin, gender, sexual preference, age, or ability status.