Volunteer Interest Form

If you would like to learn more about the program you can fill out the below interest form and we will reach out to you with more details. If you want to fully apply to the program you can select “Volunteer full application” from the drop down menu above.

Volunteer Interest Form

RurAL CAP does not and shall not discriminate on the basis of race, color, religion (creed), gender, gender expression, age, national origin (ancestry), disability, marital status, sexual orientation, or military status, in any of its activities or operations. These activities include, but are not limited to, hiring, firing of staff, selection of volunteers and vendors, and provision of services. We are committed to providing an inclusive and welcoming environment for all members of our staff, clients, volunteers, and subcontractors.

RurAL CAP intends to provide meaningful access to programs to persons with Limited English Proficiency (LEP), within parameters that do not incur undue burden on RurAL CAP resources. If you have questions or concerns, you may contact the Elder Mentor Program Manager at eldermentors@ruralcap.org

First Name

Last Name

Date of Birth

Phone

Address/PO Box

City

Zip Code

What type of Volunteer Opportunity are you interested in:

Senior Companion (volunteering with seniors)Elder Mentor (volunteering with youth)

How did you hear about this program?

If a current AmeriCorps senior volunteer referred you to the program please provide their name so they can receive a prize!

Name of referring AmeriCorp Member

Description and date of recruiting event

Please describe

Additional Comments

Contact Information

RurAL CAP Elder Mentor Program

Volunteer Interest Form