As a Volunteer!
Interested in signing up as a volunteer with the Coulee Region RSVP? If you are an individual age 55 or better, and would like to get involved by volunteering within your community fill out our enrollment form online or click on the link below to print out and complete the form. If you have printed out the form and completed it, you can either mail it into the RSVP office or drop it off in person! Please contact Amanda, with any questions at 608.785.0500.

RSVP Volunteer Enrollment Form
RSVP Volunteer Driver Enrollment Form

Name:
Gender: Male  Female
Date of Birth:
Veteran: Yes  No
Address:
City:    State:    Zip:
Home Phone:
Cell Phone:
Email:
Emergency Contact Name: *Please list someone with a different phone number than your own.
Emergency Contact Phone:
Would you like to name a Beneficiary for RSVP Supplemental Accident Insurance?: Yes  No
Beneficiary for RSVP Supplemental Accident Insurance:
Beneficiary Phone:
Beneficiary Relationship:
Employment:
Are you currently volunteering?: Yes  No
If yes, where?:
Time Available:	AM PM
Days Available:
Day(s) & Hours of Assignment:
How did you learn about RSVP?:
To assist us in making your volunteer placement successful please check all areas of interest to you.: Bulk-mailings Clerical Community Functions Disaster Services Economic Opportunities Environmental Activities Food Pantries Healthcare Facilities Home Delivered Meals Museums/Tourism Telephone Reassurance Calling Transportation Tutoring/Mentoring Veterans & Military Families Other (List below)
I give my permission for RSVP or its partner agencies to perform a background check: Yes  No
(You can click the refresh button within the reCAPTCHA to get a new image if you can't read the first one you are given.)
RSVP does not discriminate against volunteers, employees, or in the operation of any of its programs on the basis of race/ethnicity; color; national origin, including individuals with limited English proficiency; sex; age; political affiliation; religion; or on the basis of disability. Coulee Region RSVP retains all volunteer information in the strictest confidence. Personal information is not shared, transferred or sold to any third party. I volunteer my services to the Coulee Region RSVP Program and understand that I am not an employee of Coulee Region RSVP or Friends of Coulee Region RSVP, Inc. I also hold harmless Coulee Region RSVP, their employees and sponsors from any and all liability resulting from any personal injury received during the course of my volunteer activities. By hitting the submit button below I give my permission to RSVP to use my name and/or picture in news stories, newsletters, news releases, etc. to help promote RSVP.

Current Volunteer Opportunities

As a Station!
If your organization is a 501-c3 non profit and interested in collaborating with RSVP to provide volunteer opportunities for individuals age 55 and better in our community, please print out the following Memorandum of Understanding (M.O.U.), complete the attached form and return it to Coulee Region RSVP. If you need additional information or would like to set up a meeting please contact Amanda, Volunteer Coordinator, at 608.785.0500.

Memorandum of Understanding