Please fill out the application below in its entirety. Once completed, please select the "submit" button to complete the application.

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* 1. Name

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* 2. Date of birth

*Please keep in mind that you are required to be 55+ in order to be eligible to participate in this program and may be required to verify this with a government issues ID. 

Date

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* 3. Address

*Please keep in mind that at this time we are only accepting applications for individuals living in or close to Macon County.

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* 4. Phone

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* 6. Participation in this program requires that you volunteer onsite with an organization for 5 hours a week. We anticipate this beginning in May and could run through October 2025. Would you be available most weeks to complete this requirement?

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* 7. Participation in the program requires that you attend training sessions once a week on Wednesday from 9 am-1 pm and a one time orientation on March 12th from 9 am-2 pm. Are you available on these days and times to participate in this requirement for at least 12 weeks?

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* 8. An eligibility requirement to be an AmeriCorps Seniors Volunteer in this program is having personal health insurance.

Do you currently have active healthcare insurance?

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* 9. A requirement to participate in the program is the completion of a background check, including fingerprints. Are you open to completing these requirements?

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* 10. Would you have reliable transportation (I.e. personal vehicle, public transit, family member) to get to and from both the weekly trainings at the Decatur Library and your volunteer site in the Macon County?

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* 11. Please share any physical/medical limitations you may have (see Equal Employment statement, below):

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* 12. Do you feel as though you demonstrate empathy and compassion for others, enjoy connecting people with community resources and promote a healthy lifestyle?

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* 13. Please share any professional, educational, or lived experiences you have that would uniquely contribute to and enhance your involvement in this program. Previous work experience is not required to participate in this program, this question is intended to help us learn more about your background.

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* 14. How did you hear about this program and why are you interested in participating?

By signing below, I acknowledge that I have read and understand the following statements: 

I hereby state that I am 55 years of age or older and offer my services as a volunteer for the AmeriCorps Seniors Senior Demonstration Project Volunteer Program. I understand that I am not applying to be an employee of the AmeriCorps Seniors Senior Demonstration Project, The HAP Foundation, the volunteer station, or the Federal Government and agree to serve without compensation. 

I understand that holding valid health insurance is a requirement of this program and I will arrange to keep in effect active health insurance for myself for the duration of my AmeriCorps Seniors Volunteer assignment.

I understand that this application is a preliminary screening and if deemed eligible, I will be required to submit additional information, including but not limited to proof of age.

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* 15. AmeriCorps Senior Volunteer Signature

Equal Employment Agency – The HAP Foundation is an equal opportunity Agency. Enrollment is done without regard to race, color, religion, national origin, sex, age or disability. AmeriCorps Seniors Volunteers provides reasonable accommodations to the known disabilities of individuals in compliance with the Americans with Disabilities Act. For accommodation information or if you need special accommodations to complete the application process, please contact Noelle Moore, The HAP Foundation, 312-741-1289 or nmoore@thehapfoundation.org.

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