VOLUNTEER APPLICATION

Similar documents
Volunteer Application

CARING Experts ADVANCED Technology HEALTHIER Lives

I. TITLE: MEDICAL STAFF CODE OF CONDUCT MEDICAL STAFF SERVICES

UPMC POLICY AND PROCEDURE MANUAL

Novant Health Auxiliary Prince William Medical Center Haymarket Medical Center

Staff member: an individual in an employment relationship with CYM or a contractor who is paid for services.

Thank you for your interest in volunteering at Step Up on Second!

Rio Norte Junior High School Music Department Rio Norte Drive, Valencia, CA PH X 1505

Freya's Cat Rescue. a 501(c)(3) non-profit organization P. O. Box 264 Tennent, New Jersey Application for Volunteers and Interns

Emergency Contact other than Parent or Guardian (Required): Name: Relationship:

CAMP KEOLA 4-H CAMP June 19-23, 2018 CAMPER REGISTRATION NAME AGE GENDER GRADE MAILING ADDRESS CITY ZIP

Children s Hospital Los Angeles Application for Summer Junior Volunteer Program 2018 (15-17 years of age)

Volunteer Application

LOS BANOS POLICE DEPARTMENT VITAL APPLICATION PACKET TH Street Los Banos, CA Telephone (209) Fax (209)

The Marion County Sheriff s Office

Rutherford Co. Rescue

Adult and Youth/Children Safe Sanctuary Policy

1) INFORMATION ABOUT THE PARTICIPANT AND ACTIVITY

Thank you for your interest in helping to bring smiles to children with a life threatening illness and their families.

Junior High Registration

Short Term Missionary Application

APPLICATION FOR VOLUNTEER cX (7-13)

YMCA PRIMETIME PARENT/GUARDIAN:

Rancho Cielo Culinary Academy ELIGIBILITY CHECKLIST

Volunteer Application Packet

WELCOME TO VOLUNTEER SERVICE

SUMMER INTENSIVE RESIDENT ASSISTANT APPLICATION PACKET

POLICY NO Volunteer Policy (Replaces Policy Adopted 1/26/1998)

VOLUNTEER SERVICES APPLICATION (Must be 16 years of age or older.)

Chapter 2 Department Policies

Sitters At Your Service, LLC

Madera Community Hospital 1250 East Almond Avenue, Madera, CA 93637

Cristo Vive International c/o Cheryl Furst: Hwy 178 Chippewa Falls, WI 54729

Town of Southampton Police Department

Come join the Youth Ministry for fun, fellowship and a friendly game of softball with other area Catholic High School teens.

POLICY NO Volunteer Policy (Replaces Policy Adopted 12/13/2011)

Student Participant Health Form

Community Life Center

Thank you for your interest in Stamford Hospital s Junior Volunteer Program. To participate in this program, you must be at least 14 years old.

CITY OF GLENDALE APPLICATION FOR POLICE OFFICER CHECK LIST

Certificated Staff Code of Conduct

APPLICATION FOR EMPLOYMENT

Bridgepoint Health. Guide to Interpretation and Application of Code of Ethics

Girl Scouts Dakota Horizons Volunteer Policies and Procedures

How to become a Mercy General Hospital Volunteer

Mutual Respect Policy

NON-TEACHING APPLICATION

North Hawaii Community Hospital Volunteer Services Application

Girl Scouts of Greater South Texas Volunteer Policies

Student Orientation Manual

Colleton County Sheriff's Office Employment Application

Township of Lower Salford, Montgomery County 379 Main Street, Harleysville PA 19438

Student T-shirt size is: Small Medium Large XLarge 2XLarge 3XLarge (Circle one)

CALIFORNIA DEPARTMENT OF FORESTRY AND FIRE PROTECTION CDF (Page 1)

Last Name: First Name: Middle Name: Street Address: City: State: Zip Code: Home Phone: Work Phone: Cell Phone: May We Call You at Work?

EMPLOYMENT APPLICATION & INSTRUCTIONS

We look forward to meeting and learning more about you! ~ St. Luke s Volunteer Leadership Team

Membership Application February 2013

Helping others grow and excel through their interaction with horses 3498 Barclay Messerly Road Southington, Ohio 44470

KU MED Intranet: Corporate Policy and Procedures Page 1 of 6

We ll meet in the Youth Room at 2:30 p.m. and we ll return by 6:30 p.m. (depending on traffic)! For students in grades 7-12.

CODAC BEHAVIORAL HEALTH SERVICES, INC.

Group Dynamix Lock-In

How to Apply. Volunteer Services. Becoming a volunteer. Requirements. Training. Uniform. Apply today!

We are delighted that you have expressed an interest in becoming a volunteer at Bryn Mawr Hospital!

District Handbook for Club Presidents and RYLA Chair Persons Rotary District Dave Stuckey, Chair

Gilmer Independent School District 500 So. Trinity Gilmer, Texas Phone: (903) FAX: (903)

Volunteer Application

Emmanuel Hospice. Welcome to Emmanuel Hospice! Please follow these step by step directions to submit your application:

Breakaway Teen Counselor/Staff Application **COUNSELOR FEES ARE NON-REFUNDABLE **

VOLUME 2 PROHIBITED ACTIVITIES AND CONDUCT SUMMARY OF VOLUME 2 CHANGES. Hyperlinks are denoted by bold, italic, blue and underlined font.

Pawling Central School District 515 Route 22 Pawling, NY (845) (845) Fax

Attachment A: Code of Ethics for Volunteers with Vulnerable Populations

Counselor Application 2018 July 9 th 13 th

Township of Lower Salford, Montgomery County 379 Main Street, Harleysville PA 19438

A GUIDE TO THE CRANBERRY CAMPUS EMERGENCY DEPARTMENT

Claremont Police Department. Explorer Post #411. Application

If you have any questions concerning the application process, do not hesitate to contact us soon.

SPRING BRANCH COMMUNITY HEALTH CENTER

Rotary District 5180/5190 RYLA REGISTRATION FORM 2018

TWUMC APPLICATION FOR EMPLOYMENT PRE-EMPLOYMENT QUESTIONAIRE All questions must be answered completely with or without a resume.

Adventure Club. Before and After School Care Enrollment Packet. Before and After School Care Mission:

Anchor Academy Registration Form. Last Name: Middle Name: First Name: Name Used: Address: City: State: Zip Code:

VOLUNTEER APPLICATION

CITY OF ROSEVILLE, CALIFORNIA ADMINISTRATIVE REGULATION

2017 VENTURA COUNTY JUNIOR LIFEGUARD PROGRAM HELD ON SILVER STRAND BEACH IN OXNARD

Associated Students, Inc. Leadership Funding Conference Application and Guidelines

Volunteer Application and Release Form

Network Participant Credentialing Application

Last Name First Name Middle Initial Today s Date. Desired Shift Day Shift Night Shift

Handbook for Club Presidents and RYLA Chair Persons Rotary District Dave Stuckey, Chair

ANNEX B (General Officer Commander s SHARP PM, SARC/SHARP and VA/SHARP selection criteria):

SUPERSEDES: New CODE NO SECTION: Physician Services. SUBJECT: Disruptive Practitioner Behavior POLICY & PROCEDURE MANUAL POLICY:

Jelly Belly Factory. Back By Popular Demand: We will tour the

Strengthen You and Your Community: Volunteer Today!

Volunteer Firefighter Recruit Requirements and Application Procedures

PASADENA YMCA 2014 Winter Basketball Registration Form

Street Address City State Zip

I. POLICY STATEMENT REV: PRESIDENT S OFFICE POLICY ON NON-DISCRIMINATION AND HARASSMENT

APPLICATION FOR VOLUNTEERISM

Transcription:

VOLUNTEER APPLICATION We appreciate your willingness to volunteer for Reasons to Believe. Volunteers are an important part of this ministry as we seek to grow and to be good stewards of what God has entrusted to our care. Our ability to utilize volunteer help will be based on the needs of RTB at any given time and the determination of a good fit between volunteers and RTB. To apply to be a volunteer, please complete this application and return it to: Reasons to Believe, Attn: Monica Jones, 818 S. Oak Park Rd., Covina, CA 91724 Phone: (626) 335-1480 Fax: (626) 963-6504 NAME PLEASE PRINT CLEARLY ADDRESS CITY, STATE, ZIP HOME PHONE WORK PHONE CELL PHONE Is it OK to contact you at work? Yes No E-MAIL LANGUAGES SPOKEN ARE YOU 18 YEARS OLD OR OLDER? Yes No NAME OF SCHOOL, IF STUDENT Reasons to Believe - Volunteer Application Revised 8-16 1

EDUCATION/DEGREE OCCUPATION High School College Major BA MA PhD PREVIOUS WORK EXPERIENCE SPECIAL SKILLS EMERGENCY CONTACT RELATIONSHIP TO YOU HOME PHONE CELL PHONE HAVE YOU EVER BEEN CONVICTED OF ANY CRIME OTHER THAN A MINOR TRAFFIC VIOLATION IN THE LAST 7 YEARS? Yes No If yes, please explain in detail Reasons to Believe - Volunteer Application Revised 8-16 2

VOLUNTEER STATUS I am currently a volunteer for RTB. I have not yet volunteered for RTB but would like to. I have volunteered for RTB in the past. When? PREVIOUS VOLUNTEER EXPERIENCE SOME VOLUNTEER RESPONSIBILITIES MAY REQUIRE A PERSON TO DRIVE. ARE YOU WILLING TO DRIVE? Yes No If Yes, what is your driver s license # HAVE YOU EVER BEEN CONVICTED OF ANY CRIME OTHER THAN A MINOR TRAFFIC VIOLATION IN THE LAST 7 YEARS? Yes No If yes, please explain in detail WHAT DAYS ARE YOU AVAILABLE Mon Tue Wed Thu Fri Sat Sun WHAT TIME OF DAY ARE YOU AVAILABLE Morning Afternoons Evenings Whole Day If available for specific hours, please indicate: HOW FRENQUENTLY CAN YOU VOLUNTEER Weekly Monthly I am committed to volunteer, but my schedule is unpredictable. Please call me and I will help as I can Reasons to Believe - Volunteer Application Revised 8-16 3

SELECT AREAS IN WHICH YOU WOULD BE WILLING TO HELP General office (filing, photocopying, etc) Stuffing envelopes/packets for mailing Answering phones Typing, transcribing Data entry Making phone calls to solicit donations Research Anything I m glad to help Accounting Working at book table for outreaches in the area Computer programming Cataloging/inventory Editing Writing letters Computer work using Word or EXCEL Helping at RTB events (Open House, Conference...) Other areas in which I can help: HOW DID YOU LEARN ABOUT REASONS TO BELIEVE? Reasons to Believe - Volunteer Application Revised 8-16 4

WHY WOULD YOU LIKE TO VOLUNTEER AT REASONS TO BELIEVE? ADDITIONAL COMMENTS/OTHER THINGS YOU WOULD LIKE US TO KNOW? Thank you for completing this application! Our Volunteer Coordinator will contact with you within one month. Reasons to Believe - Volunteer Application Revised 8-16 5

VOLUNTEER SAFETY The safety and well being of volunteers and staff are high priorities at Reasons to Believe. In case of emergency, volunteers will be given instructions by a supervisor. It is essential, however, that volunteers follow common sense to keep themselves and others safe on a daily basis. If, at any time, you have a question about safety procedures or issues, please ask your supervisor or the Volunteer Coordinator. Volunteers must observe safety and fire regulations; must not be under the influence of or in possession of alcoholic beverages or illegal drugs on Reasons to Believe premises or while on Reasons to Believe business; or make unauthorized entrance to Reasons to Believe facilities. Reasons to Believe is a no-smoking facility. I have read and understand the policy and procedures on volunteer safety. Name of Volunteer (Please print) Signature of Volunteer Signature of Parent/Guardian if volunteer is Under 18 years of age Reasons to Believe - Volunteer Application Revised 8-16 6

EMERGENCY MEDICAL RELEASE FORM In the case of an emergency, I, the undersigned volunteer, or parent/guardian of a volunteer under 18 years of age, do hereby authorize Reasons to Believe or its representatives to consent to any x-ray examinations, anesthetic, medical or surgical diagnosis or treatment and hospital care to be rendered under general or special supervision and upon the advice of a physician and/or surgeon licensed under the provisions of the Medical Practice Act, and to consent to any x-ray examination, anesthetic, dental, surgical diagnosis or treatment and hospital care to be rendered by a dentist licensed under the provisions of the Dental Practice Act. It is understood that this authorization is given in advance of any specific diagnostic treatment or hospital care being required. This authorization is given pursuant to the provisions of Section 25.8 and Section 34.6 of the Civil Code of California. In an emergency, please notify: NAME PHONE RELATIONSHIP ADDRESS CITY ZIP NAME PHONE RELATIONSHIP ADDRESS CITY ZIP PHYSICIAN S NAME INSURANCE CARRIER PHONE PHONE PLEASE LIST ANY ALLERGIES/SPECIAL NEEDS: Name of Volunteer (Please print) Signature of Volunteer Signature of Parent/Guardian if volunteer is Under 18 years of age Reasons to Believe - Volunteer Application Revised 8-16 7

EQUAL EMPLOYMENT OPPORTUNITY AND SEXUAL HARRASSMENT POLICY It is the policy of Reasons to Believe to practice equal employment opportunity without regard to an individual s race, color, national origin, ancestry, marital status, sex, physical disability, medical condition, age or any legally protected leave of absence, in application of any policy, practice, rule or regulation. Any form of harassment, including sexual harassment, is absolutely prohibited. Any incident of possible harassment, including sexual harassment, should be brought immediately to the attention of the Vice President who will thoroughly investigate the matter. After reviewing all the evidence, Reasons to Believe will make a determination concerning whether reasonable grounds exist to believe that harassment has occurred. Disciplinary action, up to and including discharge, will be taken against any individual who is found to have engaged in harassment. Sexual harassment includes: 1. Unwanted sexual advances. 2. Offering employment benefits in exchange for sexual favors. 3. Making or threatening reprisals after a negative response to sexual advances. 4. Offensive visual conduct, including leering, making sexual gestures, displaying sexually suggestive objects or pictures, cartoons or posters. 5. Offensive verbal conduct such as making or using derogatory comments, epithets, slurs and jokes. 6. Verbal sexual advances or propositions. 7. Verbal abuse of a sexual nature, graphic verbal commentary about an individual s body, sexually degrading words used to describe an individual, and suggestive or obscene letters, notes or invitations. 8. Offensive physical conduct such as touching, assault and impeding or blocking movement. Name of Volunteer (Please print) Signature of Volunteer Signature of Parent/Guardian if volunteer is Under 18 years of age Signature of Supervisor Reasons to Believe - Volunteer Application Revised 8-16 8