Thank you for your interest in volunteering with the Aging & Disability Resource Center. Anyone who is interested in volunteering needs to complete and submit the on-line Volunteer Application Form prior to beginning volunteer service.


If you prefer to submit your application by mail, please complete the following steps:

1.) Call 715-839-4735 for information

2.) email volunteer.coordinator@co.eau-claire.wi.us


If your application is accepted, we will contact

you to set up an appointment for orientation and

training.


In the event that your application is not accepted, you will be contacted.


I look forward to hearing from you.


Sincerely,


Volunteer Coordinator

715-839-4735


Contact Information

Please complete the following required information.



Personal Information


Employment/Group/Organization

Please select your employer, group, or organization that you are volunteering through. If your group is not listed please select other. If you are not volunteering with a group please select none or leave the selection blank.



Driver License & Insurance Information

If you are applying to volunteer for any of the volunteer opprotunites that may require driving or a vehicle please complete the information requested below. By completing this section you acknowledge to and agree that you have and will maintain a valid drivers license & the required autmobile insurace coverage.


Required automobile Insurace Coverage:

-$100,000 per person and $300,000 per automobile accident liability coverage.



Reference

Please list a reference name and contact information in the text box provided. By entering the following information you agree and acknowldege that the reference provided may be contacted to complete the volunteer application screening process.



Emergency Contact

In the event of an emergency whom should we notify?



Availability

Please indicate the days and times you are usually available to volunteer within the volunteer opportunity you are interested in.



Volunteer Information Center

We provide an online "Volunteer Information Center" where volunteers may check their schedules, update their information, and receive messages. Please select the password you would like to use to access the online Volunteer Information Center.



Volunteer Agreement

I understand and agree that submitting this application form does not automatically register me as an Aging and Disability Resoruce Center of Eau Claire County volunteer, and that there may be certain qualifications I must meet, including the acceptance of established volunteer policies and procedures before I may begin volunteering.


I also understand and agree to the State of Wisconsin CCAP, Caregiver and criminal background check and National Sex Offender Registry to be completed as part of the required volunteer screening process.

By submitting this form, I attest that the information I have provided on the form is true and accurate.