Colonie Senior Service Centers has a wide variety of ways you can help... Colonie Senior Service Centers Volunteer Opportunities

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Colonie Senior Service Centers Volunteer Opportunities Colonie Senior Service Centers has a wide variety of ways you can help... Read, work on puzzles, make crafts projects one-on-one with Bright Horizons Social Centers members and help maintain their social and intellectual skills and enhance their quality of life. Lead a daily group activity like singing, dancing, karaoke, gardening, bingo, balloon volleyball, or other games; lead current events discussions, trivia contests, storytelling or remembrance activities; or chaperone Bright Horizons Social Centers members on field trips to museums, parks, restaurants, bowling, and fun-filled shopping trips. Ride the van and be a companion mornings (8 to 9:30 a.m.) or afternoons (2-3:30 p.m.) for Bright Horizons Social Centers members. You ll be helping these seniors (and their families) enjoy their Bright Horizons experience more by helping them to/from and on/off the van. Drive a van and bring Bright Horizons members on monthly field trips.* Serve lunch at one of our TEN Senior Dining Program sites. Or if you re only available evenings, serve at one of our monthly special evening dinners (usually the 3rd Monday). You ll help improve the health of seniors by serving nutritious meals in an enjoyable, social atmosphere. Duties include setting tables, serving meals, and clearing tables. Volunteer and your lunch is on us! Drive the food truck delivering group meals to off-site lunches so more seniors can benefit from this social nutrition program that brings friends together for lunch. Meals are delivered off-site 4 days a week. Volunteer and your lunch is on us!* Share your talent with seniors! LEADERS & TEACHERS for fitness, arts, humanities, & recreation programs are always welcome. Help in our Computer Lab as a COACH in the Assisted Lab or as an INSTRUCTOR for Basic Computer Classes. Have an idea for a specialized Computer Seminar such as Card Making, working with Digital Photos or Buying/Selling on EBay. If you have the know-how, share it with others! As a driver* or companion with the Good Turns Senior Escort Wagon you ll drive isolated seniors to medical appointments and wait for them so you can return them safely home. As a cashier in the Country Café you ll be providing a great service to all the visitors to the Douty Senior Center that frequent the Café for coffee, snacks, sundries and SMILES! *CDL NOT required. FOR INFO: 459-2857 x303

VOLUNTEER APPLICATION Colonie Senior Service Centers, Inc. Six Winners Circle Colonie, NY 12205 PERSONAL INFORMATION: Date: Name in Full: Address: Street City State Zip DOB: / / Primary Senior Club Affiliation: Daytime Phone: Evening Phone: Cell Phone: Email: Skills, talents & experience: Please circle all that apply General Clerical Health/Nutrition Musical Computers Fitness/recreation Arts/Crafts Food Service Fundraising Other: Transportation/Driving Teaching: (subjects) Education: Grammar School College High School Graduate School Other: Previous work/career experience: Have you ever volunteered with seniors before? Yes No If Yes where? Describe previous/current volunteer experience (include organization names): S:\Volunteers\Volunteer Packet\Volunteer Application.xls

REFERENCES: Please provide the names of (3) persons, not related to you, whom you have known at least one year. 1. 2. 3. 4'. Years Name Address / Phone Business Known PHYSICAL RECORD: Do you have any impairments, physical, mental or medical which would interfere with your ability to perform the job for which you have volunteered or which would affect your attendance? If yes, explain. If there are any positions or types of positions for which you should not be considered or job duties you cannot perform (i.e.: lifting, carrying) because of a physical, mental, or medical disability, please describe: DO NOT WRITE BELOW THIS LINE Interview and comments: By: Date: S:\Volunteers\Volunteer Packet\Volunteer Application.xls

COLONIE SENIOR SERVICE CENTERS, INC. EMERGENCY CONTACT INFORMATION VOLUNTEER NAME: ADDRESS: PHONE: DAY ( ) NIGHT ( ) IN CASE OF EMERGENCY CALL: 1. Name Address Relationship PHONE: DAY ( ) NIGHT ( ) 2. Name Address Relationship PHONE: DAY ( ) NIGHT ( ) 3. Name Address Relationship PHONE: DAY ( ) NIGHT ( ) S:\Volunteers\Volunteer Packet\Emergency Contact Information.doc

Volunteer Responsibilities Colonie Senior Service Centers, Inc. Volunteer CSSC Inc. Responsibilities 1. To make clear your interests, skills, expectations, preferences and availability. 2. Be aware of the mission of CSSC, Inc. and the program(s) you are volunteering in before accepting the assignment. 3. To accept the assignment with the intention of following through in a dependable manner, and to seek the assistance of your supervisor when needed. 4. To adhere to policies and procedures established by the organization. 5. Notify your supervisor of necessary absences as much in advance as possible. 6. To participate in the training offered by CSSC. 7. To respect the confidentiality of CSSC and/or client information. 8. To discuss with your supervisor your satisfactions, dissatisfactions, and suggestions for upgrading or changing your assignment. 9. Be willing to accept the competencies of others and work as part of a team with all staff and other volunteers. 10. To share any notable medical or physical concerns. CSSC, Inc. Responsibilities: 1. Provide a team environment that is inclusive and nurturing of all volunteers and staff. 2. Provide worthwhile and challenging volunteer opportunities that will use a volunteer s skills or help them develop new ones. 3. Provide a supervisor for all volunteers in the program. 4. Keep you informed of what s going on the organization and the program. 5. Provide a clear understanding of the job, including requirements and responsibilities. 6. Provide an orientation with staff, facilities and program. 7. Inform volunteers of the kind of records or documentation the organization will keep for you. 8. Provide In-service training opportunities S:\Volunteers\Volunteer Packet\Volunteer-CSSC Responsibilities.doc 1

Employment Screening Services APPLICANT AUTHORIZATION AND CONSENT FOR RELEASE OF INFORMATION Colonie Senior Service Centers, Inc. (the Company ) requires, as a condition of employment, and/or continued employment, that all applicants consent to and authorize a verification of the information submitted on their application or resume. Please read this statement carefully. I, the undersigned applicant, do hereby certify that the information provided by me for the purpose of employment is true and complete to the best of my knowledge. I understand that if I am employed, any false statements will be considered as cause for possible dismissal. This release and authorization acknowledges that this Company may now, or at any time while I am employed, conduct a verification of my education, employment history, credit history, and motor vehicle records. In addition this company may contact personal references and receive any criminal history record information pertaining to me which may be in the files of any Federal, State or Local criminal justice agency in any state, and/or other information as deemed necessary to fulfill the job requirements I authorize CBCInnovis Employment Screening Services and any of its agents and/or employees to disclose verbally and in writing the results of this verification process to the designated authorized representatives of this Company. The results will be used to determine employment eligibility under this Company's employment policies. I have read and understand this release and consent, and I authorize the background verification. I authorize persons, schools, current and former employers, and other organizations and Agencies to provide Employment Screening Services with all information that may be requested, and I hereby release all of the persons and agencies providing such information from any and all claims and damages connected with their release of any requested information. I agree that any copy of this document is as valid as the original. I do hereby agree to forever release and discharge this Company, its agent, CBCInnovis Employment Screening Services, and their associates to the full extent permitted by law from any claims, damages, losses, liabilities, costs and expenses, or any other charge or complaint filed with any agency arising from the retrieving and reporting of information. According to the Federal Fair Credit Reporting Act, I am entitled to know if employment was denied based on information obtained by my prospective employer, and to receive, upon written request, a disclosure of the public record information and of the nature and scope of the investigative report. If I am a resident of Minnesota, California or Oklahoma only and would like a copy of the investigative report, I will check here. Please provide all requested information and provide addresses for the last seven- (7) years (Applicant's Name, Printed - Last, First Middle) (Maiden Or Other Name(s) Used) (Current Address - Street, City, State, Zip) (Previous Address - City, State, Zip) (Previous Address - City, State, Zip) (How Long) (How Long) (How Long) (Social Security Number) (Date of Birth - for confirmation of ID only) (Name - exactly as it appears on Driver's License) (Drivers License Number) (State) [ ] Yes [ ] No (Authorization to contact present employer for reference) (Signature) (Date)