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Volunteer Information & Preferences

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Personal Information

Application Date *

Full Legal Name *

Mailing Address *

City *

State *

Zip Code *

Home Phone

Cell Phone *

Alaska Driver's License #

Expiration Date

Are you 18 years of age or older? *

YES (18+) NO (Under 18)

Service & Requirements

Performing community service for honor student credit?

YES NO

Community service for court order / probation / parole?

YES NO

Interests & Availability

What areas are you interested in volunteering for? (Select all that apply)

🍲 Meal Service (Dining Room) 🚗 Meals on Wheels Delivery 👨‍🍳 Kitchen / Baking Prep 🎨 Activities, Crafts & Bingo 📋 Front Desk & Admin 🚌 Transportation / Van Escort

When are you available?

How long will you be volunteering?

Two Personal or Professional References

Reference #1

Reference #2

Agreement & Criminal History Disclosure

CONFIDENTIALITY & RULES: All volunteer information and senior client records must be kept private and confidential. Volunteers agree to abide by all rules and regulations set forth by Nikiski Senior Citizens, Inc.

BACKGROUND CHECK DISCLOSURE: All volunteer applicants are subject to a state and federal background check prior to commencing volunteer service.

Are you aware of any criminal convictions or pending charges that would prevent you from passing required state/federal background checks? *

NO YES

Digital Signature (Type Full Legal Name) *

By typing your name above, you certify that all information provided is accurate and agree to all agreement terms.

Nikiski Senior Center

Name: Nikiski Senior Center
Address: 50025 Lake Marie Avenue, Nikiski, AK, 99611, US
Telephone: (907) 776-7654

50025 Lake Marie Avenue | P.O. Box 6973 | Nikiski, AK 99611 | Phone: (907) 776-7654

Official Form

Date: —

Volunteer Application & Agreement

Background check will be required for all applicants 18 years of age or older.

APPLICANT NAME: —

CELL PHONE: —

HOME PHONE: —

MAILING ADDRESS: —

CITY / STATE / ZIP: Nikiski, AK 99611

DL #: — (Exp: —)

AGE 18 OR OLDER? YES

HONOR STUDENT CREDIT? NO

COURT ORDER / PAROLE? NO

VOLUNTEER INTEREST AREAS:

—

AVAILABILITY: —

ESTIMATED DURATION: —

Two References:

1. None provided

2. None provided

Agreement & Terms

CONFIDENTIALITY: All information concerning clients, staff, and operations of Nikiski Senior Center is strictly confidential. Volunteers agree to maintain complete privacy at all times.

GENERAL RULES & LIABILITY: Volunteers agree to abide by all policies set by Nikiski Senior Citizens, Inc. and hold harmless the center from claims arising from volunteer services performed in accordance with policy.

BACKGROUND CHECK DISCLOSURE: All applicants understand that volunteer placement is contingent upon passing required state and federal background checks.

CRIMINAL CONVICTIONS OR PENDING CHARGES DISCLOSURE: NO

Applicant Digital Signature

___________________________

Date: —

NSC Staff Approval (Office Use Only)

___________________________

Title / Date: Executive Director / Coordinator

Nikiski Senior Citizens, Inc. — 501(c)(3) Non-Profit Organization | Form Rev. July 2026

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Volunteer Application & Agreement

Easy Online Volunteer Application

Volunteer Information & Preferences

Personal Information

Service & Requirements

Interests & Availability

Two Personal or Professional References

Agreement & Criminal History Disclosure

Nikiski Senior Center

Volunteer Application & Agreement

Agreement & Terms

Generating Formatted Application