Volunteer Acknowledgement and Agreement West Palm Beach, Florida 33407-3277 As a volunteer of, I will benefit working with other committed individuals, who are assisting people with disabilities and other barriers to employment to become self-sufficient, working members of our community. I acknowledge that I am volunteering as and my length of commitment is months. The estimated total hours per week are, which will be recorded on a Volunteer Sign-In/Out form. My scheduling is at my discretion. I understand and agree: That I must pass a background check and will provide documents that establish identity and volunteering authorization. That I am required to adhere to GGI s Safety Program. That I am required to observe and obey all policies and procedures throughout the duration of my volunteering. I agree that I have received and will return the following Company items: I hereby release and forever discharge, their Officers, Directors, Employees and assigns from any and all claims, demands, causes of actions, suits, damages, costs and expenses for any and all personal injuries; loss of profit; pain and suffering; property damage, theft or other loss arising out of or occurring in connection with volunteer efforts on behalf of I have read and fully understand this document, including the fact that I am releasing and waiving certain potential rights held by me and voluntarily and freely to the terms and conditions set forth. My signature acknowledges my understanding of and agreement with this document. Volunteer s Name (PRINT) Volunteer s Signature Date Supervisor s Signature Date VAA110426
General Information Answer all questions completely in your handwriting in ink. Submit your application to Human Resources or the office announcing the vacancy. VOLUNTEER APPLICATION West Palm Beach, Florida 33407-3277 Notify Human Resources in advance if you require special accommodation to participate in the volunteer process. I. HOW MAY WE CONTACT YOU? Your Name Social Security Number Your Address City County State Zip Code Home Phone Business Phone Add l Phone II. PERSONAL & BACKGROUND INFORMATION Are you at least 18 years of age? Yes No If required for the position, do you have a valid driver s license? Were you previously employed with Gulfstream Goodwill? Yes No If Yes, list dates of employment, where, and position(s) held: Have you ever utilized a different name? Do you have family members currently employed with Gulfstream Goodwill? Yes No If Yes name: If Yes list names: NOTE: A YES answer to the following question will not automatically bar you from volunteering. The nature, position-relatedness, severity, frequency and date of offense in relation to the position for which you are applying are considered. Failure to answer this question accurately could cause forfeiture of all rights to any volunteerism with Gufstream Goodwill. Have you been convicted or found guilty of a felony or misdemeanor, had adjudication withheld, or pled guilty or nolo contendere (no contest) to a criminal offense in the last seven (7) years, or do you have charges pending? If Yes, list the offense(s), date(s) and disposition each: II. VOLUNTEER INTERESTS Position Desired Date Available Days and hours available How were you referred to our company? Ad (Where) Employee Referral (Name) Agency (Name) Other (Please specify) Walk-in Website III. EDUCATION INFORMATION School Level Name and Location of School Course of Study Circle last grade completed Did you graduate? High School 1 2 3 4 Y N Degree or Diploma College/University 1 2 3 4 Y N Post Graduate 1 2 3 4 Y N Business/Trade Technical 1 2 3 4 Y N VA081010
Typing speed 10 key by Touch wpm PC Skills (Indicate software used) IV. SKILLS Foreign Languages (indicate proficiency to speak, read and write) Do you have any experience, training, qualifications or special skills, which you think make you especially suited to volunteer at this company? (Explain) V. VOLUNTEER/EMPLOYMENT INFORMATION - Start with your most recent employer/volunteer agency, accounting for the last 10 years. Include additional information including unemployment, self-employment and military service. Attach separate paper(s), if necessary. 1 Company Name Phone ( ) From Mo./Yr. To Mo./Yr. 2 Company Name Phone ( ) From Mo./Yr. To Mo./Yr. Yes No 3 Company Name Phone ( ) From Mo./Yr. To Mo./Yr. 4 Company Name Phone ( ) From Mo./Yr. To Mo./Yr. VI. ACKNOWLEDGEMENT & CERTIFICATION Please read carefully and sign below I agree to provide proof of any professional certification and/or educational accomplishments as required. Further, I authorize any person, school, current employer (except as expressly noted), past employer(s), and organizations named in this application form (and accompanying resume or other documentation, if any) to provide Gulfstream Goodwill with relevant information and opinion, personal or otherwise, that may be useful in making a hiring decision. I release all parties from all liability for any damage that may result from furnishing information and opinion to the Gulfstream Goodwill. I also understand that, should an offer to volunteer be made, background checks, including criminal, workers compensation and motor vehicle reports, will be conducted. In consideration of volunteering, I agree to obey the rules and standards of Gulfstream Goodwill. I understand that nothing contained in this application or in the interview process is intended to create a contract between Gulfstream Goodwill and myself for employment.. I understand that as a condition of our workers compensation insurance a post-accident alcohol/drug test will be required if I am involved in a onsite-related incident. I further understand I may be required to take an alcohol/drug test if management reasonably suspects a condition exists that prevents me from performing my position in a manner that endangers my own health or the safety and health of others. I understand that all offers of volunteering are conditioned upon my providing satisfactory documentary proof of my identity and successful completion of all background information. I hereby acknowledge that I have read the above statements and understand them. I certify that I, the undersigned applicant, have personally completed this application. I declare that the facts contained in the application (or any resume or other documents submitted) are true and complete to the best of my knowledge. I understand that any misrepresentations or omissions will disqualify me from further consideration for volunteering, and will result in my dismissal from volunteering, if discovered at a later date. Signature: Date: VA081010
VOLUNTEER AUTHORIZATION FOR RELEASE OF INFORMATION West Palm Beach, FL 33407 (561) 848-7200 / Fax: 848-1475 This release and authorization acknowledges that ( Gulfstream Goodwill ), may now, or at any time while I am volunteering, conduct a verification of my education, prior employer verification and workers compensation claims/injuries, and motor vehicle records; contact personal references; require that I provide a urine or blood specimen to be tested for the presence of drugs or alcohol as the result of an incident or due to reasonable suspicion; and receive any criminal history record information pertaining to me that may be in the files of any federal, state, county, or local criminal justice agency and/or other information as deemed necessary to fulfill the job requirements. Medical and workers compensation information will only be required in compliance with the Federal Americans with Disabilities Act and/or any other applicable state laws. The results of this verification process will be used to determine volunteer eligibility under Gulfstream Goodwill s volunteer policies. By signing below, I hereby authorize without reservation, any party or agency contacted by this Gulfstream Goodwill to furnish the above-mentioned information, and I hereby release all of the persons and agencies providing such information from any and all claims and damages connected with their release of information. I further authorize ongoing procurement of the above-mentioned reports at any time during my time of volunteering. I also agree that a fax or photocopy of this authorization with my signature be accepted with the same authority as the original. I have read and understand this consent for release of information and I authorize a background verification. According to the Federal Fair Credit Reporting Act, I am entitled to know if my request for volunteering was denied or terminated based on information obtained by Gulfstream Goodwill and to receive, upon request, a disclosure of the public record information and of the nature and scope of the background report. Volunteer Position offered: Department Code/Location: Print your name: Maiden and/or former name: Street Address: City, State & Zip: Date of Birth: Social Security # Drivers License # State Applicant Signature: Date: VAFR0810
GULFSTREAM GOODWILL INDUSTRIES, INC. VOLUNTEER SIGN IN/OUT FORM VOLUNTEER NAME LOCATION VOLUNTEER PERIOD BEGINNING DATE (MONDAY) VOLUNTEER PERIOD ENDING DATE (SUNDAY) WEEK 1 DATE Time-In Time-Out Time-In Time-Out TOTAL Monday Tuesday Wednesday Thursday Friday Saturday Sunday TOTAL VOLUNTEER HOURS WEEK 1 WEEK 2 DATE Time-In Time-Out Time-In Time-Out TOTAL Monday Tuesday Wednesday Thursday Friday Saturday Sunday TOTAL VOLUNTEER HOURS WEEK 2 TOTAL HOURS VOLUNTEER NAME, SIGNATURE & DATE SUPERVISOR'S NAME, SIGNATURE & DATE Copies: Volunteer Supervisor Human Resources