St. Anthony Park Area Seniors

2200 Hillside Avenue

St. Paul, MN 55108


Volunteer Application




Name: ________________________________________Today’s Date ______________

            First name      Middle name        Last name

Address: ________________________________________________________________


Permanent Address _______________________________________________________


Previous Addresses (in last seven years): ________________________________________________________________________




Previous Names (like maiden name, other married names);________________________




Phone: (Home) _____________ (Work) _________________ (Cell) ______________


Email: __________________________________________________________________


Birth date: _______________________





Please list paid and/or volunteer positions. Indicate with a * position(s) in which you are currently working. Attach additional information if desired.


  1. _________________________________________________________________
  2. _________________________________________________________________
  3. _________________________________________________________________
  4. _________________________________________________________________


** Have you ever been convicted of a felony?  [ ] yes  [ ] no

** Have you ever been convicted of a misdemeanor: [ ] yes  [ ] no

If checked yes, please explain: ____________________________________________




High School __________________________________________________________


College or University ____________________________________________________________________


Special Training or Skills _______________________________________________



Areas of Volunteer Interest


Please circle your areas of interest.


Visitor                                     Home helper                           Event organizing

Provide transportation            Office mailings                        Computer assistance

Board member                         Committee member                 Caregiver respite visitor

Dog walker                              Fundraising                             Blood pressure checks

Run errands                             Wash windows                       Handyman skills

Do laundry

Meals on Wheels driver          Exercise class leader (substitute)   “Dream grantor”

Seasonal chores (raking, snow removal, lawn mowing)                     

Other, specify ______________________________




Days of the Week _____________________________________________________


Time of Day _________________________________________________________


Can you make a six-month commitment to our program? [ ] yes  [ ] no


If no, how long are you able to commit to volunteering? _______________________


If matched with a senior citizen as a friendly visitor, are you able to commit to making contact with the senior once very two weeks?

(Contact includes phone calls, mailings, and personal visits.)


[ ] yes  [ ] no   Comments_________________________________________________






What type of activities do you enjoy doing for fun or leisure?






Are you fully vaccinated for Covid-19? Yes ___ No ___



If you will be using your car for your volunteer work, please complete:



Driver’s License Number:__________________  Expiration date: _______________


Auto Insurance Company: ______________________________________________


Policy Number: __________________  Expiration date: ______________________


Is your driving record free and clear?  [ ] yes  [ ] no

If no, please explain: ______________________________________________



I attest that the above information is true and accurate and that St. Anthony Park Area Seniors is not responsible for any personal injury or auto damage incurred while volunteering.


________________________________________                ______________

Signature                                                                                 Date



How this Information is Used


We need the above information to help us to keep track of our volunteers.  This information, as well as the hours that you report as a volunteer, helps us to secure the funds that we need through the government and private grants.  We will also use the information provided in this application to check public databases for past criminal activity.  If something comes up, it does not necessarily mean that you will be disqualified.  We want to make appropriate assignments for our volunteers and our senior participants. 


We assure you that we never give out any personal information without the volunteer’s permission.  We keep all volunteer personal paperwork in a locked office filing cabinet, which is only accessible to office staff.  We shred any documents that are no longer needed that contain any personal information.