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RSVP of Central Oklahoma Volunteer registration form
Volunteer Registration Form
Please complete all sections. Forms with original signatures are required for enrollment.
RSVP of Central Oklahoma Volunteer Application Form
ZIP / Postal Code
Do you have any physical/medical limitations?
Describe your physical limitations:
Are you a past member of RSVP?
Are you a Veteran?
Do you drive?
Driver License Number
I prefer not to respond
(You are not obligated to disclose your ethnicity. We request this information to only comply with federal civil rights laws.)
Have you ever been convicted of a criminal offense?
If yes, please attach an explanation of charges, date of offense and status of the charges on a separate sheet to be included with this application.
How did you learn about RSVP?
Have you ever volunteered before?
Volunteer Experience (Current, Past, Preferred)
As a volunteer, you will receive free accident and personal liability insurance. Please provide the following information.
Name of beneficiary for RSVP Supplemental Accident Insurance
Please indicate if RSVP may have permission to use your likeness?
I hereby grant RSVP of Central Oklahoma to use my likeness in photographs/videos in any and all of its publications or on the World Wide Web, whether now known or hereafter existing, controlled by RSVP of Central Oklahoma in perpetuity. I will make no monetary or other claim against RSVP of Central Oklahoma for the use of these photographs/videos.
I do not give permission to use my likeness in photographs/videos to RSVP of Central Oklahoma.
Please indicate if RSVP may have your permission to perform a confidential background check?
I understand that RSVP may at their own expense and discretion choose to perform confidential background checks on any/all registered members. I hereby give my permission for such checks to occur.
I do not give permission to perform confidential background checks.
By signing below, I acknowledge that I have read and understand the following statements: 1) I hereby state that I am 55 years of age or older and offer my services as a volunteer for RSVP of Central Oklahoma. I understand that I am not an employee of RSVP of Central Oklahoma, the volunteer agency in which I serve, or the Federal Government and agree to serve without compensation. 2) I understand that in my capacity as a RSVP volunteer I may come into contact with confidential information. I agree to protect this information to the best of my ability and not to disclose it during or after my service as a volunteer has ended. 3) I understand that if I use my personal automobile in my volunteer service, I will arrange to keep in effect automobile liability insurance equal or greater to the minimum requirements of the state of Oklahoma. I will also keep in effect a valid driver’s license.
Please type name here for Signature: