Form Center

2. Name*
3. Last Name*
5. Address*
6. City*
7. Zip Code*
9. Telephone Number 1*
10. Telephone Number 2
11. Email Address*
13. Position of Interest

    Please select which position(s) you are interested in:

15. Volunteer Positions

    1. Desk receptionist
    2. Decorating
    3. Fitness Center
    4. Kitchen/Dining

    1. Library
    2. Scheduler
    3. Special Events
16. Other:

    Please specify. 

18. Acknowledgment

    By typing my full name and date below, I affirm that all information provided in this application is true and accurate.  I authorize the City of Beavercreek to complete an application verification to assist in determining my suitability as a volunteer. I also acknowledge that false statements are grounds for not being accepted.

    I further understand that volunteers are not covered by workers' compensation, and I will not hold the City of Beavercreek liable for injuries while volunteering for the City.

20. Signature*
21. Date*
23. Thank you!

    Thank you for your interest in volunteering for the City of Beavercreek's Senior Center! A member of our team will be in touch with you shortly. 

Leave This Blank:


26. 1. Receive an email copy of this form.
27. Email address

    This field is not part of the form submission.

28. Submit

* indicates a required field