Please complete this application form if you are interested in volunteering with the Foster Grandparent Program or the Senior Companion Program. Once you complete the form, click the 'continue' button.

Name and Address

Please enter your basic information and how you can be contacted.

Demographic Information

Please provide the following information. It is used to help us get a better idea of the demographic make-up of our volunteers.

Our Programs

Select which program(s) you would like to be a volunteer for and list how many hours you'd like to volunteer daily, weekly, or monthly.


Volunteers will have access to public transportation, or may choose to drive their own vehicle. Please choose whether you would like to drive your own vehicle or take public transportation/carpool, and provide your driver's license information.

Background Check

Please be advised: All applicants must undergo criminal background checks before placement. Refusal to consent to criminal background checks will immediately deny eligibility for enrollment in program. Persons with records of sexual offenses will not be allowed to serve in the Senior Companion or Foster Grandparent Programs. Other prior arrests will not automatically preclude enrollment, based on the discretion of project and volunteer station staff. Please answer the following question.

Income Verification

Please be aware: In order to receive a stipend, income eligibility guidelines must be met. In the next step of the application process you will need to provide proof of your income.

Getting To Know You

Please provide a response to the questions below.

Email Preferences

We like to keep volunteers informed of important news, schedules, and volunteer opportunities by email, however will not send you any email you prefer not to receive. Use the checkboxes below to select the kinds of email you would like to receive from us.


I certify that the information furnished above is correct and understand that falsification of information may result in my being deemed ineligible.