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2. PRIVACY NOTICE
   PLEASE NOTE: ANOKA COUNTY TAKES YOUR PRIVACY VERY SERIOUSLY. WE WILL TAKE EVERY AVAILABLE PRECAUTION TO MAINTAIN THE SECURITY AND INTEGRITY OF YOUR PRIVATE INFORMATION. PRECAUTIONS HAVE BEEN TAKEN TO MAKE ANOKA COUNTY’S WEBSITE AND E-MAIL SECURE, BUT ABSOLUTE SECURITY IS NOT GUARANTEED. IF YOU CHOOSE TO SUBMIT YOUR INFORMATION ELECTRONICALLY, YOU ASSUME ANY RISKS ASSOCIATED THEREWITH.
4. Your Information
6. First Name*
7. Last Name*
9. Address1*
11. Address2
13. City*
14. State*
15. Zip*
17. Phone*
18. Email Address
20. How did you hear about RSVP?
22. Currently volunteering at
24. How do you plan to travel to your volunteer assignment?*

    This information is required for your liability insurance benefits. Check all that apply.

    1. Drive (you will be asked to submit your DL# and insurance info by phone call)
    2. Ride with friend/spouse
    3. Bus/AC Traveler
    4. Walk
26. RSVP WELCOMES ALL VOLUNTEERS 55+.

    The following 3 questions are optional.

28. Race/Ethnicity

    Optional

29. Sex

    Optional

31. Are you a U.S. Veteran?
    Optional. If you choose to answer, please respond with "yes" or "no."
35. Designation of Beneficiary
37. Name*
38. Phone*
40. Address*
41. Relationship*
45. Emergency Contact
47. Name*
48. Phone*
50. Address*
51. Relationship*
55. More about your interests
57. Preferred Locations
    All positions located in Anoka County; please specify if you’d like to only volunteer in a certain area of the county.
59. Other skills, interests, or limitations

    Please specify anything else you’d like us to know when matching you with volunteer opportunities. (Examples: professional skills you’d like to share in a volunteer setting or restrictions you want us to be aware of.)

61. RSVP Volunteer Interests/Skills
    Please check the interest/skills that you have and would like to use as a RSVP volunteer. They will be entered in the RSVP skills bank and used to match volunteers to community needs. Based on your interests, you will be sent descriptions of volunteer opportunities to choose from. Training will be provided for all positions.
63. Arts/Entertainment

    1. Art Center Volunteer
    2. Gardening (Light)
    3. Nature Center Volunteer
    4. Photographer
    5. Theater
64. Basic Needs

    1. Prepare Clothing Donations
    2. Food Shelf Volunteer
    3. Food Shelf Driver
    4. Day Center Volunteer with Homeless Program (Weekdays, Weekends)
    5. Sewing/Quilting/Knitting
    6. Deliver Meals/Food
    7. On-line grocery order-taker
    8. Distribute recovered food (Manna Markets)
65. Education

    1. Assist at Local Public School
    2. Assist at Local Public Libraries
    3. Assist users' with organizations respective technology
    4. Adult Education
    5. Adult Basic Education Tutor
    6. Computer Lab Tutor
    7. English-as-Second-Language Tutor
    8. Homework Help
    9. Health Insurance Counselor (Medicare)
67. Health Services

    1. Bloodmobile Volunteer
    2. Hospital Volunteer
    3. Regional Treatment Center
    4. Coffee/Gift Shop Volunteer
68. History Center

    1. Carpenter
    2. Cataloger
    3. Performance Reader
    4. Photo Recorder
    5. Research
    6. Tour Guide/Walking Guide
    7. Special Events
69. Miscellaneous Support

    1. Mediation Volunteer
    2. Bicycle Repair
    3. RSVP Advisory Board Member
71. Office/Computer Support

    1. General Office/Clerical
    2. Grant Writer
    3. Database Manager
    4. Senior Information Line support
    5. Receptionist/Greeter
72. Senior Care

    1. Companion/Visit Senior at Caregiver's Home to Give Caregiver Time Off
    2. Assist at Group Respite Site for Caregivers and Care Receivers
    3. Volunteer with local Assisted Living enrichment programs
73. Short Term Projects

    1. Cleaning
    2. Fundraiser Events
    3. Handyman
    4. Mailing Projects
    5. Special Events
75. Tax Form Assistance

    1. Income Tax Preparation Volunteer
    2. Property & Mobile Tax Volunteer
    3. Electronic Return Originator (IT/Computer Experience Helpful)
    4. Tax Site Greeter
76. Transportation

    1. Deliver Meals/Food
    2. Drive Seniors or Veterans to Medical Appointments
    3. Recover school lunches or food from local stores
80. Signature
    Please check the confirmation box to confirm that you have read and understand the following statement:
    • I hereby state that I am 55 years of age or older and offer my services as a volunteer for the Anoka County Retired Senior Volunteer Program. I understand that I am not an employee of the RSVP Project, the sponsor, Anoka County, the volunteer station, or the Federal Government and agree to serve without compensation.
    • If I drive my own vehicle I will keep my automobile insurance updated.
    • By enrolling in RSVP, I understand that my name and/or picture may be used in news stories, newsletters, news releases or slide presentations to help in promoting the Program.
82. Confirmation*

    1. I confirm
83. Your Full Name*
    Please enter your full name as an electronic signature
Leave This Blank:


85. 1. Receive an email copy of this form.
86. Email address

    This field is not part of the form submission.

87. Submit

* indicates a required field