AARP Arkansas Volunteer Application
Please rank areas of interest (select from list of roles in information packet, e.g., Advocacy, Communications, etc.):
1.__________________________________
2.__________________________________
3.__________________________________
Mr./Mrs./Ms./Miss/Other_____: (Circle One)
Name: ____________________________
Address: ________________________________________ Apt. ________
City: _________________________
State: _______Zip Code: ______________
Home Telephone: _______________
Mobile Telephone: ___________________
Fax Number: ____________________
Email: ___________________________
AARP Membership No: _________________
Nickname: ___________________
May we contact you via e-mail regarding information pertinent to AARP-Arkansas and its initiatives? Yes____ No_____
Interests/Program Areas: (It would help us to know other areas that may interest you. Please check all that apply.)
Interest Areas:
___ Helping at Special Events
___ Helping Others with Managing Finances
___ Communications & Newsletters
___ Influencing Lawmakers & Others
___ Community Activities
___ Management
___ Consumer Protection
___ Public Relations/Publicity
___ Education/Teaching/Presenting
___ Working with Children
___ Health & Fitness
___ Working with Older Adults
AARP Programs
___ AARP Driver Safety Program
___ AARP Tax-Aide Program
___ AARP Grief & Loss Program
Where did you hear about this volunteer opportunity? _______________________
Skills: (please check all that apply)
___Advocacy/Promoting Issues
___ Languages, Specify_______________
___ Training/Facilitation
___ Clerical/Administrative
___ Leadership
___ Volunteer Recruitment
___ Community/Grassroots Organizing
___ Public Speaking
___ Writing/Editing
___ Computer Literacy
___ Research
___ Other_______________________
Availability: When are you available to volunteer?
Weekdays: Day ___ Evening ___
Weekends: Day ___ Evening___
Assignments: Short-term ___
Long-term (1-2 year commitment) ___
As needed___
Where: My town/city ___ My county ___
My state___ Outside the state___
Education:
High School Diploma/GED___
College Degree ___
Advanced Degree___
Certifications: _______________________________________________
Past Experiences: Have you volunteered for AARP before? Yes___ No___
If yes, when and in what capacity? __________________________________________
Please share with us past experiences that you would like to use in your volunteer work.
____________________________________________________________________________________________________________________________________________
List other volunteer experiences: ___________________________________________ ______________________________________________________________________
______________________________________________________________________
Please attach a resume, if available.
Personal Information:
AARP attempts to achieve a balance of age, gender, and ethnicity in its programs. You are not required to provide this information. It is being collected for program evaluation purposes only.
Birth Date: ___________________
Gender: Female ___ Male___
Race/Ethnicity:
African American___
Native American___
Asian___
Hispanic/Latino___
Caucasian___
Other ___
Employment Status:
Full-time ___
Part-time ___
Retired___
Emergency Contact:
Name: ______________________________ Relationship: ________________
Address: _________________________________________ Phone: _________________
AARP supports legislative activities on both state and federal levels. Therefore, all volunteers will be asked to provide support on an as-needed basis with AARP advocacy efforts. This assistance may be as minor as making a phone call or writing a letter regarding an AARP priority issue to your legislator. When representing AARP, volunteers may not express opposition to AARP public policies or positions. If there is not an approved policy on an issue, volunteers may not express a position on behalf of AARP. If a volunteer is unclear about whether or not AARP has taken a position on a public policy, guidance and clarification should be sought from the volunteer’s supervisor or other appropriate AARP representative.
A volunteer is expected to exemplify a high standard of personal and professional behavior. Each individual with whom the volunteer works is to be treated with dignity and respect. AARP encourages its volunteers and employees to become involved in cooperative relationships.
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I hereby attest that the information I have provided in this application is true to the best of my knowledge, and I hereby agree to the above policy.
Signature: ________________________________________
Date: ________________
For the next step in the application process, an AARP-Arkansas staff member or volunteer leader will call you to set up an interview. Thank you for your interest!
For Office Use Only: Received Date: _______
Referred for Interview Date: _______
Approval Signatures: ____________________________________________________________
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