RSVP Application

Return to TCOG AmeriCorps Seniors

Would you prefer to download the application and fill it out by hand? Just download the file by visiting this link

RSVP Application FormRSVP Application Form

RSVP Volunteer Membership Application

Your name*
Prefix First Middle Last
Date of birth*
MM slash DD slash YYYY
Current age*
Please enter a number greater than or equal to 55.
You must be at least 55 years of age or older to enroll in this program.
Shirt Size*
Home address*
Street Address Address Line 2 City State ZIP Code
Home phone*
Mobile phone
Email*
Enter Email Confirm Email
Demographic Data
Please select all that apply to you. This data is for statistical information only. Submission of information is voluntary.
Gender
- Male
- Female
Marital status
- Single
- Married
- Divorced
- Widowed
Veteran
- Yes
- No
Additional demographics
- American Indian or Alaska Native
- Asian
- Black or African American
- Hispanic or Latino
- Native Hawaiian or Other Pacific Islander
- White
If there are any special accommodations needed to assist you in service, please list below:
I am applying to volunteer at:
Previous/Current Occupation
Previous/Current Employer
Referred to RSVP by:
Where do you currently volunteer?
Volunteer Opportunities
- I am not currently volunteering and would like to know of volunteer opportunities available.
Free Supplemental Auto Liability Insurance Information
RSVP is required to carry supplemental accident and personal liability coverage for its volunteers.
Driver's License Number
Expiration Date
MM slash DD slash YYYY
Insurance
Copy of Driver's License or State-issued ID
Max. file size: 128 MB.
If possible, please include a copy of your Driver's License or State-issued ID.
Method of transportation
- Own car
- Ride with a friend
- TAPS
Free Accidental Life Insurance Beneficiary Information
All RSVP members receive free accidental life insurance. Please designate your beneficiary or to your estate.
Beneficiary Designation*
- Please designate benefits to my beneficiary
- Please designate benefits to my estate
Beneficiary Name*
First Last
Relationship
Phone Number*
Beneficiary Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Texoma RSVP Volunteer Interests/Skills
Administrative
- Select All
- Office - filing, receptionist, greeting
- Telephone - answering, calling
- Computer skills
- Tax preparation
Advocacy
- Select All
- Elder Care - Medicare, legal assistance
- Nursing Home Ombudsman
- Homeless - mental health, housing, education
- Crisis hotline
General
- Select All
- Household skills - carpentry, building, handy person, general maintenance
- Kitchen aid - baking, cooking, serving meals
- Driving - transporting others, delivering meals
- Gardening - outdoor plants maintenance / conservation
- Fundraising - event planning for RSVP or other nonprofit agencies
- Knitting/Crocheting - special projects for others in need
- Schools - tutoring, reading, mentoring
- Special events - (short term): county fair, fundraising, mass mailing
- Thrift store work
Health
- Hospice - caregiver respite, patient visits
Can you be called upon in case of a natural disaster in our area such as flood, tornado, etc.?
- Yes
- No
Additional interests not listed above
Terms and Conditions*
I agree to the Terms and Conditions
I hereby request to enroll as a participant in the RSVP Volunteer Program. I understand that my service is voluntary and I agree to serve without compensation. I certify that I am at least 55 years old and that I maintain automobile liability insurance equal to or greater than the minimum required by state law.
Email
This field is for validation purposes and should be left unchanged.

RSVP Application FormRSVP Application Form

RSVP Volunteer Membership Application

Demographic Data

Free Supplemental Auto Liability Insurance Information

Free Accidental Life Insurance Beneficiary Information

Texoma RSVP Volunteer Interests/Skills