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Council on Aging Membership Application/Renewal

  1. Type of Submission*
  2. Representing*
  3. Do you personally live in Chesterfield County?*
  4. CCA Committee Participation*

    Chesterfield Council on Aging members demonstrate their commitment to our mission through action. Committees are small group planning teams that set the course for Council engagement with Chesterfield citizens. Please review the committee descriptions and select which, if any, committees where you plan to serve in the coming year. The chair person of that committee will contact you with meeting times and projects in progress.

  5. Code of Ethics*

    I will exhibit respect for the residents and community we work with and serve, and integrity in my actions and responsibility for my decisions and consequences.

    As it relates to my role on the Council on Aging, I am committed to:

    • Acting honestly, truthfully and with integrity in all my transactions and dealings;
    • Appropriately handling actual or perceived conflicts of interest in my relationships;
    • Treating every individual with respect, courtesy and dignity. Avoiding insensitive or offensive language. Refraining from engaging in physical, verbal or emotional violence toward each other;
    • Acting responsibly toward the community in which I work and serve;

    The CCA will not permit behavior that exhibits a lack of integrity or ethics. CCA Executive Committee will take disciplinary action up to and including permanent dismissal of my membership if my behavior exhibits a lack of integrity or ethics.

  6. Leave This Blank:

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