Membership Application

Coming of Age Membership Application
  • **If you request mileage reimbursement, please complete the following fields:

    (if not please advance to the following section)
  • (end mileage reimbursement section)
  • Agreement

    I understand that I am not an employee of engAGE Travis County; their local sponsor Travis County; their federal sponsor AmeriCorps Seniors; or my volunteer agency. I am under no obligation to continue as a volunteer and may discontinue my service at any time. I will submit monthly reports to Coming of Age which provide the total hours I volunteer, the agency name and the total number of clients served (if applicable). If requesting mileage reimbursement; a W-9 MUST be on file, beginning and ending odometer readings must be given for each volunteer trip and forms cannot be over three months old. If I use my personal automobile in reporting to and from a volunteer station, I will arrange to keep in effect automobile liability insurance in accordance with Texas law. I grant full permission to engAGE Travis County for use of my name, photographs, videotapes, or other recordings of participation in engAGE Travis County activities.
  • This field is for validation purposes and should be left unchanged.