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Teaching Seniors Technology Volunteer Form

  1. Title II Compliance

    In accordance with the requirements of Title II of the Americans with Disabilities Act (“ADA”) of 1990, the Fair Employment & Housing Act (“FEHA”), the Rehabilitation Act of 1973 (as amended), Government Code section 11135 and other applicable codes, the City of Modesto (“City”) will not discriminate against individuals on the basis of disability in the City’s services, programs, or activities. For more information, please visit the City of Modesto website.

  2. Age Requirements*
    Please select the appropriate box. You must be at least 15 years old (with parental consent) to participate as a volunteer in the program.
  3. Volunteer Commitment *
    How long would you like to volunteer for this program?
  4. Time Availability *
    This program takes place from 2:30PM-4:00PM every Wednesday
  5. Select the day you would like to begin
  6. Weekly Volunteer*
    How many weeks would you like to volunteer?
  7. Volunteer Waiver
    Every single volunteer must turn in a signed waiver before participating. You can find the waiver online. Please print and sign the waiver. Return the waiver to our office, 211 Bodem Street in Modesto, using one of the below options.
  8. Method for Returning Waiver
  9. Please fill out the form and save it to your device prior to choosing this method.
  10. Please read carefully before submitting this document.
  11. Leave This Blank:

  12. This field is not part of the form submission.