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Shepherd's Center of Northern Virginia

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Participant Application

Home › Participant Application

Thank you for your interest in becoming an SCNOVA Participant. Participant is the term we use for the older adults we serve. If you want to receive services such as Transportation, Food Delivery, Friendly Caller, Friendly Visitor, and Minor Home Repair, please first complete a Participant Application here. You do not need to complete a participant application for AIL, Caregivers Support, Health & Wellness classes, or Social Events – although all our participants can avail themselves of these services.

There are two ways to complete a Participant application:

  1. fill out the online form below (preferred), OR
  2. download the Participant Application HERE, fill it out, sign and return it either by email (to: online@scnova.org) or by mail (to Attn: Volunteer, SCNOVA, 111 Church St NW, Suite 202B, Vienna, Virginia 22180).

*Please complete every portion of the application. Incomplete applications WILL NOT BE ACCEPTED.

*Please remember in order to become a participant of the Shepherd’s Center of Northern Virginia you must reside in: Oakton, Vienna, Dunn Loring, Merrifield, Reston, Herndon, Great Falls or Fairfax (north of rt. 50), Virginia.

*Area codes we service are: 22031, 22033, 22124, 20171, 20170, 20190, 20191, 20194, 22180, 22182, 22181, and 22027.

*If you have questions or need assistance, please contact our office at (703) 260-9568.

Complete the online Participant Application below

Step 1 of 3

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  • This field is for validation purposes and should be left unchanged.
  • Please complete the rest of the Application with only the Applicant's information
  • MM slash DD slash YYYY
    You or another in the household having a physical or mental condition that affects your mobility, strength, balance, or ability to perform daily activities. Examples may include arthritis, chronic pain, vision loss, hearing loss, difficulty walking, or using mobility aids such as canes, walkers, or wheelchairs.
  • Emergency Contact
  • Please read the information below which includes eligibility requirements and guidelines for all new participants.

    Eligibility Requirements for Participant Services
    Adult must be 50+ years of age or older
    Must live in Oakton-Vienna-Reston-Herndon-Great Falls (we do handle a small portion of Fairfax, and will notify potential participants whether they are out of the service area during the initial call to our office)
    Must be ambulatory; use of a cane or walker is acceptable.

    Guidelines- for Free Transportation Service
    Office hours are Monday-Friday, 10am – 4pm. You must speak to a SC Office Volunteer for your ride request to be processed by calling: 703.281.0538.

    When making an initial contact allow at least THREE business days before your appointment. (Exceptions may be made in the event of an emergency at the discretion of the office staff).

    Remember: No ride is ever guaranteed, and same day service is not available.

    Provide the following information when making a service request:
    Full name, address, and phone number of the doctor, therapist, or trip destination
    Time, date and duration of the appointment.
    For most medical/dental appointments, you may be charged if you do not cancel within 24 hours of the appointment. We will try to let you know the day before if no driver has picked up your request. However, if you have not heard from a driver or SC Office Volunteer the day before your requested date, you should make other arrangements for transportation.

    If you have a Monday appointment the SC Office Volunteer will call you on Friday if no volunteer has picked up the ride.

    It is up to the discretion of the driver whether any additional stops can be made. Participants are limited to a maximum of 3 rides drives per week, depending on driver availability.

    All arrangements for your transportation are to be made through the Shepherd’s Center. Call the office immediately if your appointment is changed or cancelled.
    703.281.5038. Participants are not to call volunteers at home unless to convey a cancellation of a drive after office hours.
    Participants are responsible for paying any tolls or parking fees.
    Drivers will take participants to appointments in most areas in Northern Virginia.
    If an appointment or ride is cancelled, participants should contact the office to let us know.

    Requirements for Medical Transportation

    Please bring a current listing of all medications, including dosage amounts.
    Have the contact information for your primary care physician.
    Have Emergency Contact Information on hand.

    Services Provided

    Medical and Companion Transportation (groceries, hairdresser, banking, etc.)
    Handy Helpers
    Friendly Callers
    Friendly Visitors
    Veterans Initiative
    Special Educational and Social Events

    Please call the office or check the website for details on each service.


    Remember everyone who performs a service for the Shepherd’s Center is a Volunteer. Please be considerate of their time and treat them with the same courtesy that you expect and deserve.

    Lastly, thank you for your cooperation with these guidelines. If you have any questions or concerns about them, please contact the office. We welcome you as a new participant of the Shepherd’s Center of Northern Virginia and we look forward to serving you in the future!

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Services We Offer

  • Caregivers Support Group
  • Friendly Caller Program
  • Friendly Visitor Program
  • Health & Wellness
  • Minor Home Repairs
  • Senior Citizen Transport
  • Social Events
  • Service Territories
Seniors outside laughing and hugging

You can make a difference in someone’s life today.

Helping in any way makes a difference.

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SC Nova Logo White
111 Church St. NW
Suite 202B
Vienna, VA 22180
(703) 260-9568

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Since 1998, the Shepherd’s Center of Northern Virginia (SCNOVA), a 501(c)(3) non-profit organization, has been dedicated to improving the quality of life as we age, through supportive programs and services, personal enrichment and volunteer engagement that enable our senior neighbors to live full and productive lives while aging in place.

Services

  • Caregivers Support Group
  • Friendly Caller Program
  • Friendly Visitor Program
  • Health & Wellness
  • Minor Home Repairs
  • Senior Citizen Transport
  • Social Events
  • Service Territories

Resources

  • About
  • Blog
  • Board and Staff
  • Contact
  • Testimonials
  • Mission
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Popup Modal: Giving Tuesday 2025

Giving Tuesday 2025

Support SCNOVA This December 2

Giving Tuesday is December 2, 2025. Your support will make a powerful difference in the lives of older adults who rely on SCNOVA for free transportation to doctors’ appointments, grocery stores, banks, and other essential destinations. Through these programs, many isolated older adults can participate in community events, attend social lunches, and make new friends. Every contribution, no matter the size, helps enrich the lives of our neighbors and ensures that no older adult feels alone.

Participate in Giving Tuesday

Thank you for supporting our community.