NEST Collaborative Volunteer Application Form

Thank you for your interest in becoming a NEST Collaborative Volunteer (NEST = Nevada Ensures Support Together) to help support elders and adults living with disabilities. We are excited to welcome you to our team!

Once you complete the form, please click the ‘Continue’ button at the bottom of the page.

First, please tell us how to contact you:

First name:

Last name:

Title:

Nickname:

Street 1:

Street 2:

Street 3:

City:

State:

* Zip: *

Main phone:

* OK to call me here

Other phone:

OK to call me here

Email address:

Now tell us a little more about you.

Date of birth:

Education:

Degree & area of study:

School:

If you are currently a student, please list the institution where you are currently enrolled.

Languages Spoken

What languages (including English) do you speak fluently?

How did you hear about us?

Please tell us how you heard about the opportunity to volunteer with The NEST Collaborative.

Nevada Affiliations

If you are a professional or a volunteer working in social services, aging services, or in a healthcare organization in Nevada, please indicate the group or organization's name, your position and what functions you perform here (include licensing agency and license number if applicable).

Availability

What days and times are you available to volunteer?

Volunteer Area of Interest

Please tell us which NEST Collaborative volunteer opportunities most interest you:

1. Provide one-to-one friendly calls to a list of assigned elders and/or adults living with disabilities.

2. Host virtual social connections for a small group of 2-5 elders and/or adults living with disabilities.

3. Provide telephone-based technical assistance to elders and/or adults living with disabilities via one-to-one coaching and mentoring. Serve as a resource for elders as they familiarize themselves with technology as a way to address their needs.

* Volunteer preference:

1. One-to-One Calls Volunteer [The NEST Collaborative]

2. Peer Social Groups Volunteer [The NEST Collaborative]

3. Tech Assistance Volunteer [The NEST Collaborative]

Times

Assignment

References

Please list one personal or professional reference.

First name:

Last name:

Work phone:

Email address:

Relationship:

About you

Please provide a few sentences about yourself that we can give to the Participants you'll be serving, so that they can get to know you a bit before your first conversation! This information will also be shared with your Volunteer Guides (who will help to support you throughout your volunteer service) and the other Volunteers in your Volunteer cohort (i.e. the other Volunteers also being supposed by you Volunteer Guides)

Example, What are your hobbies? What are most passionate about? What is one of your hopes or dreams? Where do you call “home”?

Background Check

In order to volunteer for The NEST Collaborative, you must consent to a background check. You may have already received one if you have volunteered recently or if you hold a professional license. If you have actively served as an aging services volunteer in the past six months, please let us know with which organization you've served. If you're a licensed professional of any kind, please provide that information, along with any applicable license numbers.

If you have not already received a background check (details above), you must consent to a background check in order to volunteer with the NEST Collaborative. By checking the box below, you are stating that you would be willing to consent to a background check. This background check will be conducted through Verified First (https://verifiedfirst.com) and will require some personal information (including a social security number). You will receive communication directly from Verified First regarding your background check.

Additionally, by checking the box below, you grant the NEST Collaborative the right to use any success stories that you might share for the purposes of program reporting and promotion.

I Agree