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Volunteer with Central Iowa RSVP
Your preferred method(s) of contact:
Are you bilingual?
Do you have any health or physical conditions to be considered in arranging volunteer activities?

Emergency Contact

Volunteer Benefits

All RSVP volunteers are covered by supplemental insurance including excess automobile liability, accident, personal liability, and life insurance while volunteering.  This coverage is automatic and free of cost to you.

Do you drive?

RSVP volunteers are eligible to be reimbursed for mileage expenses incurred while volunteering.  If you plan to request this benefit, please check below.

I understand that if I use my personal automobile to drive for my volunteer assignment, I will keep in effect automobile liability insurance equal to or greater than the minimum required by Iowa law.  I will also keep in effect a valid driver's license.

Personal Skills/Qualifications

Personal skills/qualifications are acquired through employment, previous volunteer work, or other activities such as hobbies or sports.  Please list any special skills or interests you have that you would like us to consider in offering volunteer opportunities (for example - photography, carpentry, gardening, music, technology).

Volunteer Interests

Check each box next to the volunteer activities you may be interested in.  Please note that this is a general list of possible assignments and that some of these activities may not be available at all times or in your geographic area.

EDUCATION
HEALTH / WELLNESS / NUTRITION
COMMUNITY PRIORITIES & SPECIAL PROJECTS
PUBLIC HEALTH/SAFETY & EMERGNCY PREPAREDNESS
Assist Law Enforcement:
Public Health Response
Volunteer Reception Center (VRC) - Managing spontaneous volunteers activated in an emergency
Other
Do you have a current Iowa Driver's License?
Do you have a commercial driver's license?
Do you or have you had professional licensure in any field?
I agree to have Central Iowa RSVP enter the following contact information into the emergency notification system so that I can be notified in the event of an emergency/activation request.
ADDITIONAL AREAS OF PREFERENCE

Consents & Signature

By signing this, I certify that the information provided is correct. Your information is never sold, shared, or used outside of Central Iowa RSVP.

May we use your photo for publicity?
Do you, or have you ever, had to report to a Probation Officer?
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