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Senior Center Volunteer Application

  1. If you selected "College Degree," please list your area of study

  2. Volunteer Interest Areas (check all that apply)*

  3. Liability Waiver

    I understand that my services are being offered on a voluntary basis without anticipation of financial remuneration. I shall indemnify and hold harmless the Village of Waunakee, its Board and their officers, agents and employees from and against all claims, demands, loss of liability of any kind or nature for any possible injury incurred during volunteer service.

  4. Background Check

    I understand that a background screen will be conducted through a background reporting agency.

  5. Confidentiality

    I understand that volunteers are responsible for maintaining the confidentiality of all privileged information to which they may be exposed while serving as a volunteer. This information may include personal information about staff, participants, and other volunteers or overall agency business.

  6. Signature*

  7. Leave This Blank:

  8. This field is not part of the form submission.