My image/name may be included in print/social media Yes No

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1 Volunteer Application 2018 Due: April 20 th for DOH & June 2 nd for WOH Volunteer Fees DOH - $10* WOH - $20* *Youth Scholarships Available Youth/Adult: Youth (age by event date) Adult (21 or older) Preferred Work: Crew Worker Site Advisor Hospitality Other Name Gender Date of Birth School/Occupation Grade Address Cell Phone Home Phone City, State Zip Parent/Guardian Parent Cell Parent Affiliation: First Presbyterian Church of Washington St Joseph s St. Luke s Lutheran The Chapel Trinity UMC UMC of Washington WC Habitat Warren Hills HS Other: Circle T-shirt size: S M L XL 2XL 3XL My image/name may be included in print/social media Yes No Do you have any special skills, expertise, preferences, concerns that you would like to share? Are there any medical/personal challenges/limitations or other information we should know? Please initial each statement to show your agreement with each: This is a Christian mission event whose purpose is to extend the love of God to others through service & to grow in faith in our own walk with God. I accept these purposes as my own and commit to helping others do the same. I agree to attend training meetings and participate in fundraising to the best of my ability. I commit to a FULL DAY/WEEKEND and will not leave my worksite early. I have read the code of conduct provided by Hope in the Hills of Warren and will agree to it. I understand that my emergency information and contact information will be distributed to other team members and will only be used for mission team purposes. If I am 21 or older, I certify that I am not currently suspended or otherwise prohibited from operating a motor vehicle and, in the past three years, I have not pleaded guilty to nor been convicted of driving under the influence of alcohol or illegal drugs. I also agree to inform HHW if there is any change in my driving status. If I am 21 or older, the church/group and HHW has my permission to keep a copy of my driver s license and insurance card on file. I will produce it upon request. Applicant s Signature Parents/Guardians of Youth Volunteers I have read the code of conduct provided by HHW and agree to it. I understand that emergency information and contact information will be distributed to other team members and will only be used for mission team purposes. My youth participant is committing to a FULL DAY/WEEKEND of daily work and will not leave the worksite early. I give permission for my child to attend. Applicant s Signature Date Date Choose 1 or both events Day of Help April 28, 2018 Weekend of Hope June 22 (orientation), 23-25, 2018 Both Events

2 Volunteer Skill Assessment Name: Date: This survey helps us assign work crews. Please be accurate in the estimation of your skills. Specify your skills according to the following levels: 0 = no skill and not willing to attempt 1 = haven t done yet, but willing to try 2 = have done but need guidance 3 = can do well independently 4 = can do well and guide others 5 = working in trade Applicable to both Day of Help and Weekend of Hope Events Applicable to Weekend of Hope Only Skill Level Skill Level Skill Level Pastor Debris removal Light Plumbing Cook Heavy lifting Roofing First Aid/CPR Skills Tear out drywall, Insulation flooring Will you use a step ladder? Carpentry Framing Drywall Hanging Will you go on 6-8 ladder? Carpentry Finish Drywall Finishing Will you go on an extension Siding Spackling ladder? Adults Only Will you lead a Masonry Interior Painting crew? brick/plaster Is there anything on a typical job site Flooring vinyl, etc. Exterior Painting that is a concern for you? Cabinet installation Weeding Do you have any special skills or experience? Flooring vinyl, etc. Window Installation Landscaping

3 Youth Code of Conduct Keep This Page for Your Records Please read, keep for your records, and initial appropriate place on application acknowledging agreement. I will respect the spiritual growth and work goals of the work team and participate in all scheduled activities, which are designed to make the most of my mission experience. I will not act or behave in a way that creates significant distractions or disruptions to other participants or staff. To respect the people of the community and other workers from diverse denominations and organizations, I will dress and behave modestly. The community will expect our dress and behavior to be different as a Christian organization. I will respect all property and not damage any property. I will respect those around me by not using obscene or abusive language or engaging in reckless behavior that could cause harm to others or myself. To help the trip time be focused on interacting with God and others, I will not bring electronic video devices, computers, or toy guns. I understand there is no security for valuables. In order to build relationships with my group, my crew, and others at HHW events and activities. I will not text message or use my cell phone, ipod, MP3 player, etc. on worksites or during worship programs. I may use my cell phone to call the HHW office or respond to an emergency. For my safety, I will not leave the meeting center or project sites without an adult if I am under 21. I will not have in my possession or use fireworks, firearms, weapons of any kind which includes knives, illegal drugs, or alcohol. I will obey all the laws of the community and state in which I am serving. I know that illegal activity will not be tolerated and that local police will be called if necessary. To respect others, I will not use tobacco in vehicles, at the project site, at any HHW facility, or in neighboring residents yards. I understand it is illegal to use tobacco on most church and school grounds. I will respect and follow the directives of my adult leaders, other trip adults, and trip staff. I will respect others by avoiding inappropriate sexual activity. I will not engage in sexual misconduct, which can include inappropriate comments, gestures, or physical contact. I have read and understand this Code of Conduct. It is out of respect for God, myself, and others that I abide by these rules. If I violate these rules, I may be denied the privilege of participating in the mission trip. I may be asked to leave (without reimbursement of expenses or registration, departing at my own/families expense) at the request of my church/organization leader or HHW/Habitat leaders. Personal health insurance is not required of participants to attend the mission trip, although recommended. All participants are asked to bring personal health insurance information with them if they have it. If they re treated at a hospital or other health-care facility, they ll be asked to provide this information. Any costs not covered by the participant s own insurance are the responsibility of the participant or his or her parent/guardian. TRIP COSTS & REQUIREMENTS: The cost for these events: DOH $10 and WHO $20 per event per youth participant. Additional funds are gained via fundraising in which you will be expected to participate/contribute. Please submit a check with this application made out to HHW. You will also be asked to bring basic tools and painting supplies. Adults 21 and older must supply proof of a background check (no older than 5 years). We will run a safety orientation and will ask you to sign off that you were trained in Habitat Work Crew Safety and Construction Safety at that time. During weekend dates, youth and adult volunteers will complete minor home repairs at no cost to homeowners throughout Warren County. The work is traditionally performed on the homes belonging to the elderly, low-income families, and/or those with disabilities. Additionally, those we are serving depend upon their assigned teams to complete the work to their homes. As such, all volunteer workers are required to attend all scheduled workdays and attend full days. We cannot accommodate volunteer workers who require a shorter week or must leave early on certain days. Mission trips are highly interactive, potentially physically demanding, require close proximity to others, require longer hours than typical, require working in all types of weather including rain & very warm weather, require flexibility and adaptability, require the ability to listen to and follow directions given by authority figures, require safe and responsible behavior at all times and require the ability to get along with others who may be unfamiliar to you. In order to facilitate a safe and productive trip for all involved, it is essential that you disclose all pertinent personal, medical, social, emotional, behavioral or other issues with your church or group leader. It is essential that all issues be discussed openly in order to make accommodations necessary. This information is considered confidential and will be reviewed by your group s trip coordinators, the HHW committee leaders and a pastor. Your permission will be requested if this information will need to be shared with any other person. Pertinent issues not divulged or not fully shared on this form and become later known by the coordinator and HHW may result in dismissal from the trip. Team Assignments: Team assignments are based on the needs of the worksite and volunteer skill level. Typically, family members are assigned to different teams. This is part of our community-building process, building connections between volunteers from various churches and organizations. All adults are screened with background checks and every team member is carefully placed. If you have questions about this or specific needs, you must contact the HHW organizer directly at the time of application to discuss your questions and concerns.

4 Adult Code of Conduct Keep This Page for Your Records Please read, keep for your records, and initial appropriate place on application acknowledging agreement. I will show respect to all trip participants. I will act as a positive role model. I will not act or behave in a way that creates significant distractions or disruptions to other participants or staff. I will follow all the trip rules that youth are expected to follow as is attached in the Youth Code of Conduct. Regarding safety, I will be alert to any potential safety risks and take action to prevent injury to other participants or myself. I will not have in my possession or use fireworks, firearms, weapons of any kind except for knives/tools to be used on the job sites under adult supervision, illegal drugs, or alcohol. I will obey all the laws of the community and state in which I am serving. I know that illegal activity will not be tolerated and that local police will be called if necessary. To respect others, I will not use tobacco in vehicles, at the project site, at the lodging facility, or in neighboring residents yards. I understand it is illegal to use tobacco on most church and school grounds. I know trip attendance means working in a very close community for an extended period of time. All adults are expected to respectfully correct the inappropriate actions of any participant, even if he or she is not part of my group. I will support the trip staff by encouraging my group s youth and adults to follow the Code of Conduct, schedules, and trip processes. In order to build relationships with my group, my crew, and others at the mission trip, I will not text message or use my cell phone, ipod, MP3 player, etc. on worksites or during worship programs. I may use my cell phone to call the trip office or respond to an emergency. I will show respect to all other youth and their adult leaders. I will not ridicule or humiliate youth. I will be an encourager of youth, particularly in my crew during the trip week. I understand there is no secure place to hold valuables and am discouraged from bringing any. I will model respect for others and avoid inappropriate relationships. I will direct my time and attention to all, rather than selected, youth and adults with whom I serve, work, and associate. I have read and understand this Code of Conduct. It is out of respect for God, myself, and others that I abide by these rules. If I violate these rules, I may be denied the privilege of participating in the mission trip. I may be asked to leave (without reimbursement of any expenses or registration) at the request of my organization/church leader or HHW/Habitat leaders. Personal health insurance is not required of participants to attend the mission trip, although recommended. All participants are asked to bring personal health insurance information with them if they have it. If they re treated at a hospital or other health-care facility, they ll be asked to provide this information. Any costs not covered by the participant s own insurance are the responsibility of the participant or his or her parent/guardian. If I have a youth of my own attending the mission trip and he/she is asked to leave due to a breach of safety or the code of conduct, I may be asked to leave as well in order to take care of my child. There will be no reimbursement of any payments. TRIP COSTS & REQUIREMENTS: The cost for these events: $10 Day of Help and $20 Weekend of Hope per participant. Additional funds are gained via fundraising in which you will be expected to participate/contribute. Please submit a check with this application made out to HHW. You will also be asked to bring basic tools and painting supplies. Adults 21 and older must supply proof of a background check (no older than 5 years). We will run a safety orientation and will ask you to sign off that you were trained in Habitat Work Crew Safety and Construction Safety at that time. During weekend dates, youth and adult volunteers will complete minor home repairs at no cost to homeowners throughout Warren County. The work is traditionally performed on the homes belonging to the elderly, low-income families, and/or those with disabilities. Additionally, those we are serving depend upon their assigned teams to complete the work to their homes. As such, all volunteer workers are required to attend all scheduled workdays and attend full days. We cannot accommodate volunteer workers who require a shorter week or must leave early on certain days. Mission trips are highly interactive, potentially physically demanding, require close proximity to others, require longer hours than typical, require working in all types of weather including rain & very warm weather, require flexibility and adaptability, require the ability to listen to and follow directions given by authority figures, require safe and responsible behavior at all times and require the ability to get along with others who may be unfamiliar to you. In order to facilitate a safe and productive trip for all involved, it is essential that you disclose all pertinent personal, medical, social, emotional, behavioral or other issues with your church or group leader. It is essential that all issues be discussed openly in order to make accommodations necessary. This information is considered confidential and will be reviewed by your group s trip coordinators, the HHW committee leaders and a pastor. Your permission will be requested if this information will need to be shared with any other person. Pertinent issues not divulged or not fully shared on this form and become later known by the coordinator and HHW may result in dismissal from the trip. Team Assignments: Team assignments are based on the needs of the worksite and volunteer skill level. Typically, family members are assigned to different teams. This is part of our community-building process, building connections between volunteers from various churches and organizations. All adults are screened with background checks and every team member is carefully placed. If you have questions about this or specific needs, you must contact the HHW organizer directly at the time of application to discuss your questions and concerns.

5 Adult Background Check Standards & Requirements Keep The Top of This Page for Your Records All adult participants (age 21 and older) that participate in HHW events and activities must submit to a background check. We ask for a Multi-State Criminal Record/Sexual Offender Search. Background checks cannot be more than five years old. Participants must submit proof prior to participation in any HHW program. Proof will be held by the HHW coordinator in a confidential file in the HHW or Habitat office. RETENTION OF RECORDS HHW and/or Habitat keeps a copy of the background check on file for a period of six years from the date of the mission trip. ADULT PARTICIPANT DISQUALIFICATION For the sake of participating as an adult, the following behaviors discovered in a background check will automatically disqualify a person without review or recourse: Sexual crimes involving children, youth or adults resulting in conviction Violence against another person resulting in a felony conviction within the last 10 years Use, or distribution, of illicit drugs or controlled substances in the last 10 years Property crime resulting in conviction in the last 10 years We cannot make exceptions to this requirement for any reason. USE OF INFORMATION: If disqualified based on the above criteria, this information will be shared with the HHW coordinator, church/group or organization leader/pastor so that he/she can determine further action such as participation of the adult in other youth-related activities as per the general church/group/organization conduct policy. METHODS TO SATISFY THE BACKGROUND CHECK REQUIREMENT Submit proof that you have a completed, clear background check valid within the last 5 years. To aid in the processing of background checks for adults volunteering for Hope in the Hills of Warren, we can perform a background check for you for $10. Complete the form below and mail along with a $10 check made out to First Presbyterian Church of Washington to HHW Volunteer; 31 Belvidere Ave.; Washington, NJ The form and payment must be received 3 weeks prior to the HHW event. Request for Background Check for HHW Adult Volunteers First Name Middle Last Maiden Date of Birth Social Security Number Address City State Zip Home Phone Cell Phone Office Use Only Request Received: Date: By: Volunteer Cleared Background check Yes Date: By: performed: No