Create Volunteer Profile

Welcome to the Senior Concerns Volunteer Information System (CERVIS). Thank you for your desire to serve as part of the Senior Concerns team. Please complete the information requested below to submit your application for review. 


Once we receive your application we will contact you directly to see how we can match your interests to our open volunteer positions. Please note that if you feel we are a good match then we will prompt you to complete an online background check. 


We are so thankful for your interest and look forward to serving with you!

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Volunteer Last Name:*
Volunteer First Name:*
Volunteer Primary Phone:*
Volunteer E-mail:*
Confirm E-mail:*
Volunteer Password:*
Confirm Password:*
Volunteer Alternate Phone:
Volunteer Address:*
Volunteer Address Line 2:
Volunteer City/Town:*
Volunteer State:*
Volunteer Zip Code:*
Emergency Contact Name:*
Emergency Contact Phone:*
How did you learn about Senior Concerns? (1000 character max)
List any specific skills or qualifications you might like to utilize at Senior Concerns: (1000 character max)
Volunteer Birth Date:*
Are you interested in being an event team leader?*
Upload Volunteer Profile Photo:
Choose Image

(.jpg or .jpeg format only and less than 5MB in size.)
Volunteer Interests:*

Waiver and Release:

I release and forever discharge and hold harmless Senior Concerns  and its successors and assigns from any and all liability, claims, and demands of whatever kind or nature, either in law or in equity, which arise or may hereafter arise from the activities as a Volunteer with Senior Concerns, including claims arising out of negligence. I understand and acknowledge that this Release Discharges Senior Concerns from any liability or claim that I may have against Nonprofit with respect to bodily injury, personal injury, illness, death, or property damage that may result from the services the Volunteer provides.


Insurance: I affirm that I am covered by primary medical insurance and understand that I am responsible for my medical bills if injury occurs. I affirm that if my role involves driving a car that I hold a current and valid drivers license as car insurance.


Photographic Release: I, grant and convey to Senior Concerns all right, title, and interests in any and all photographs, images, video or audio recordings of the Volunteer or his or her likeness or voice made by Nonprofit in connection with the Volunteer participating in Nonprofit events, including but not limited to, any royalties, proceeds, or other benefits derived from such photographs or recordings.


Confidentiality Statement & Agreement
By submitting this application, I agree to treat all information I may hear, see, read or otherwise acquire at Senior Concerns as highly confidential and I will not reveal or discuss this information outside my official duties at Senior Concerns.
Furthermore, by signing this application, I affirm that all information stated in this application is true and complete to the best of my knowledge and that any false statements, omissions or misrepresentations made by me could result in termination of my volunteer duties at Senior Concerns, Inc


General Volunteer Guidelines/Rules
1. All volunteers are under the supervision of the Senior Concerns staff unless otherwise notified.
2. Should you or any other person at Senior Concerns, the Senior Concerns Bargain Boutique or anyone on a Meals On Wheels route have an accident or are injured while on duty, report the information immediately to the Senior Concerns staff person in charge. Staff must complete an accident report. It is your responsibility to carry your own medical insurance.
3. Wear appropriate clothing for the type of activity in which you will be involved. No heels or open toe shoes please.
4. Notify Senior Concerns as soon as possible if you cannot volunteer on your scheduled day. Call us at 805-497-0189.
5. Volunteers may not solicit, hand out business cards, or advertise their services, or the like, to Senior Concerns participants, participant’s families, donors, volunteers or staff.
6. A volunteer may be removed from the program when there is reasonable cause to do so. Reasonable cause may include, but is not limited to the following: extended absences, inability to accept supervision, failure to observe safety rules and/or Senior Concerns policies and divulging confidential information.
7. As you perform your duties, please remember you are a representative of Senior Concerns and our goal is to treat all patrons and staff with enthusiasm and respect.
8. Observe all safety precautions to limit exposure to COVID19 for yourself and the people we serve. This includes washing hands for 20 seconds with soap before and after work is done. Keep a 6-foot distance
between yourself and our clients. If you have any cold or flu symptoms refrain from doing volunteer work and call to let us know. Do not enter anyone’s home.
9. If you are concerned about the well being of a client or have cause to believe there is abuse or neglect going on in the home, report this immediately to Senior Concerns staff so an Adult Protective Service
report can be made.
10. No entering the client’s home and no hugging of clients as a protective measure against spread of the Coronavirus. You are required to maintain a 6-foot distance between yourself and the client.
11. Senior Concerns will provide to you, if needed, a cloth mask, hand sanitizer and gloves to ensure your safety