VOLUNTEER APPLICATION

Similar documents
ICM Food & Clothing Bank Volunteer Application

The Family Crisis Center of East Texas, Inc. (Women s Shelter of East Texas)

Volunteer Application

HPNAP FOOD GRANT APPLICATION SOUP KITCHENS

Internship Application Student Teacher Acceptance

YMCA OF MIDDLE TENNESSEE AUTHORIZATION AND RELEASE FOR THE PROCUREMENT OF A CONSUMER AND/OR INVESTIGATIVE CONSUMER REPORT

In order to qualify as a Member of the Flagler Hospital Auxiliary, volunteers shall:

North Carolina Extension Master Gardener Volunteer Application Guilford County

Camp Rainbow Application 2016

North Hawaii Community Hospital Volunteer Services Application

Guidelines for Volunteer Chaplains

COMPEER PROGRAM VOLUNTEER APPLICATION

VOLUNTEER APPLICATION

Sitters At Your Service, LLC

BREINING INSTITUTE 8894 GREENBACK LANE ORANGEVALE, CALIFORNIA USA TELEPHONE (916)

CAMP AT THE EASTWARD A Youth Ministry of Mission at the Eastward

SAISD Volunteer Information Packet

Fairfield Medical Center volunteers serve in a wide variety of departments and are valued members of our healthcare team.

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

TEEN VOLUNTEER APPLICATION (AGES 16-17)

SUMMER INTENSIVE RESIDENT ASSISTANT APPLICATION PACKET

BREINING INSTITUTE 8894 GREENBACK LANE ORANGEVALE, CALIFORNIA USA TELEPHONE (916)

EMPLOYMENT APPLICATION

HIGH-SCHOOL STUDENT VOLUNTEER PROGRAM

There are no application fees to be granted the MATC, although you will need to pass the on-line MATC Exam or complete the MATC Education Course.

Fairfield Medical Center volunteers serve in a wide variety of departments and are valued members of our healthcare team.

Lighthouse Youth & Family Services Volunteer & Intern Application

EQUAL EMPLOYMENT OPPORTUNITY DATA FORM Please Return to: City of Geneva Human Resources 22 South First Street Geneva, IL 60134

North Carolina Extension Master Gardener Volunteer Application Caldwell County

2018 CAMP Registration Packet. Boyertown YMCA PHILADELPHIA FREEDOM VALLEY YMCA

Must provide copy of college/university enrollment confirmation.

Beacon Rules for Clients

LIVING WORD CHRISTIAN SCHOOL CODE OF ETHICS

Signature (Patient or Legal Guardian): Date:

JUNIOR AMBASSADOR SUMMER PROGRAM APPLICATION Age: Date of Birth: Parent/Guardian s

CODAC BEHAVIORAL HEALTH SERVICES, INC.

Last Name First Name M.I. Name You Prefer. City State Zip Address. Daytime Phone Evening Phone Best Time to Call. City State If yes, where?

Mary Washington Hospice Volunteer Application Form 5012 Southpoint Parkway Fredericksburg, VA BUS: (540) FAX: (540)

Middletown Summer Youth Employment Program. Summer 2018

Fairfield Medical Center volunteers serve in a wide variety of departments and are valued members of our healthcare team.

WHAT IS CAMP ENTERPRISE?

Student Participant Health Form

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

VOLUNTEER APPLICATION

VOLUNTEER APPLICATION

2018 State Funded Youth Employment Program

WHO DO I CONTACT WITH QUESTIONS? Our team is happy to answer any questions or address any concerns that you may have.

2018 CAMP Registration Packet. Roxborough YMCA PHILADELPHIA FREEDOM VALLEY YMCA. Important Registration Information:

Children s Advocacy Center for Denton County (CACDC) Undergraduate Internship Application

WHO DO I CONTACT WITH QUESTIONS? Our team is happy to answer any questions or address any concerns that you may have.

2018 Alexandria 4-H Summer Day Camp- Lights, Camera Cooking Registration Form

CARSON CITY VOLUNTEER/INTERN APPLICATION. Volunteer/Intern Name: City, State, Zip: Day Phone: Night Phone: Cell Phone:

Thank you very much for your interest in volunteering for Make-A Wish Minnesota! Becoming a volunteer is easy, just complete these steps:

How to become a Mercy General Hospital Volunteer

Please return your completed application to

APPLICATION FOR VOLUNTEERISM

Compliance Program And Code of Conduct. United Regional Health Care System

Wyoming County Employment Application

U.S. Army Aeromedical Research Laboratory Gains in the Education of Mathematics and Science Program PARTICIPANT APPLICATION

Application For Employment

Rotary District 5180/5190 RYLA REGISTRATION FORM 2018

Basic Information. Date: Patient s Name: Address:

VOLUNTEER INFORMATION SHEET. A safe secure environment may warm their bodies... but only people can warm their hearts...

Junior Leadership Merced. Class APPLICATION

APPLICATION FOR EMPLOYMENT FIREFIGHTER / PARAMEDIC POSITION

2018 Application Colorado Master Gardener Volunteer

Coast Capital Savings Reading Buddy Program Volunteers WANTED!

APPLICATION FOR EMPLOYMENT

Roosevelt Care Center. Volunteer Service Application

Return Completed Application To: ARISE & Ski, 635 James Street, Syracuse, NY 13203

2018 Application Colorado Master Gardener Volunteer Pueblo County

VOLUNTEER APPLICATION

C.A.R.E.S. PROGRAM, 2018 FEBRUARY VACATION REGISTRATION Registration Deadline Tuesday January 9, 2018

COUNTY OF SACRAMENTO Probation Department

If you are currently a High School Senior. you will complete a general volunteer application, not this one.

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

What are the benefits of being a summer camp program staff member at Holiday Lake 4-H Educational Center? Weekly salary (Starting at $215 for 1st

2016 GFWC Success for Survivors Scholarship

BIOGEN FOUNDATION. This program will be available to all current Biogen U.S. employees and members of the Board of Directors.

Washington State Historical Society. Update

Volunteer Application (Please print)

Atlanta Community Scholars Awards Graduating High School Senior. Program Description & Guidelines. Eligibility Criteria

Application for Admission

EMPLOYMENT PROCEDURES FOR SUBSTITUTE TEACHING STAFF

Volunteer Application

THE HUMANITARIAN, INC. Creating Vision Through Mentoring

APPLICATION FOR EMPLOYMENT Wallace Community College Selma

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

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

World Trade Center Health Program FDNY Responder Eligibility Application

NEW PATIENT PACKET. Address: City: State: Zip: Home Phone: Cell Phone: Primary Contact: Home Phone Cell Phone. Address: Driver s License #:

Applicant must have taken the ACT/SAT Test at least once and submit their scores.

Teton County Sheriff s Office Jim Whalen Sheriff

ADMISSION INFORMATION

NON-TEACHING APPLICATION

Hospitality Guidelines

!!! Program Referral Checklist. Assessment for Determining Eligibility. Vocational Rehabilitation Needs. Medical and Psychological Reports

STEAM COACHES PROGRAM Application Package

ILLINOIS CHARTERED ASSOCIATION OF DECA

Application for Admission Nurse Aide Training Program

Transcription:

Orientation Date: Raiser s Edge: An Equal Employment Opportunity / Affirmative Action Employer VOLUNTEER APPLICATION Prospective volunteers will receive consideration without discrimination due to race, color, religion, creed, gender, sexual orientation, national origin, age, disability, marital, military or veteran status or any other legal protected status. Please complete all the sections below and return to: St. Vincent de Paul Administrative Offices, 124 W. Apple St. Dayton, OH 45402, or email to volunteerinfo@stvincentdayton.org. Please send to the attention of the Manager of Volunteers. PERSONAL INFORMATION (PLEASE PRINT CLEARLY) Name: Last First Middle Initial Nickname/Preferred Name: Address: Date of Application: E-mail: Primary Phone: Date available to begin: Home Cell Work/Business City: State: Secondary Phone: Home Cell Work/Business Zip Code: - Date of Birth: month day year Gender: Female Male Social Security No. (Optional): GENERAL INFORMATION How did you hear about St. Vincent de Paul? If you currently volunteer with or have previously volunteered with a group at St. Vincent de Paul, please indicate which group and volunteer position: Why would you like to volunteer for St. Vincent de Paul? Have you ever worked with low-income, mentally ill, drug-addicted or formerly incarcerated individuals? Yes No Do you need to complete volunteer hours for school or work? If yes, explain and include total hours required: Do you have felonies or misdemeanors, not including traffic? If yes, explain: Name and relationship of relatives working for St. Vincent de Paul: (This information will be used only in conjunction with personnel policy on work assignments of relatives) Have you ever been employed by St. Vincent de Paul? Yes No If yes, please state position, start date, end date of employment and reason for leaving: Have you ever been a resident or participant of a St. Vincent de Paul Program? If yes, explain: 1

EMERGENCY CONTACT INFORMATION 1 st Emergency Contact Name: Phone Number: Relationship: Home Cell 2 nd Emergency Contact Name: Phone Number: Relationship: Home Cell CODE OF ETHICS I have read the Code of Ethics for Volunteers of the Society of St. Vincent DePaul and will keep a copy of it for my records. I fully understand its content and agree to abide by it. Signature: Date: PHOTO RELEASE I hereby grant the St. Vincent de Paul Society District Council of Dayton, Ohio, Inc. permission to use my likeness in any photograph, video or other digital or print reproduction (the Materials ) in any and all of its publications, including websites and social media, without payment or any other consideration. AGREE DECLINE Signature: Date: STUDENT VOLUNTEERS (UNDER THE AGE 18, PARENT/GUARDIAN SIGNATURE REQUIRED) I give my permission for read and reviewed the code of ethics with him/her. I give my permission for please select one: AGREE DECLINE to volunteer for the Society of St. Vincent de Paul. I have also to be photographed in relation to his/her volunteer position, Parent/Guardian Printed: Signature: Date: 2

EDUCATION Highest Level/Last Year Completed: School: Do you have a degree? Yes No If yes, what is your degree in? Please list any licenses or certificates? EMPLOYMENT EXPERIENCE Name of current employer: Phone No: Street Address: City: State: Zip Code: Position Held: Does your employer sponsor or encourage community service days? Yes No Does your employer offer special recognition for volunteering? Yes No Does your current or former employer offer matching funds? Yes No VOLUNTEER EXPERIENCE SKILLS & TALENTS (PLEASE MARK ALL THAT APPLY): Arts & Crafts Construction/ Carpentry Sewing Building Repairs/Painting Visual Arts: Drawing/Painting Event Planning Music/ Musical Arts Fundraising Photography Legal or Financial Writing Social Media/Networking Languages: Basic Advanced - Computer Skills Cooking/Nutrition Graphic/Web Design Please list any other special skills or areas of interest: 3

AREAS OF INTEREST FOR VOLUNTEERS Please check all areas that you are available to assist with: GATEWAY SHELTERS Serving Breakfast Men (6AM-7:30AM) Provide/Donate a Fixed Meal Serving Breakfast Women (5:30AM-7AM) Front Desk-Apple (hours vary 6AM-9PM) Serving Breakfast Families (6:45AM-8AM) Front Desk-Gettysburg (hours vary 6AM-9PM) Serving Lunch Women (10:30AM-12PM) Clothing Sorter (hours vary 8AM-4PM) Serving Lunch Families (11:30AM-1PM) Donation Door (5PM-8PM Weekdays, between 9AM-4PM Weekends) Serving Lunch Men (11:30AM-1PM) Laundry (8:00AM-12:00PM) Serving Dinner Women (4:30PM-6:00PM) Men s Dorm Assistant (6:30PM-8:30PM) Serving Dinner Families (5:45PM-7:30PM) Women s Dorm Assistant (6:30PM-8:30PM) Serving Dinner Men (6:30PM-8PM) Family Dorm Assistant (7PM-9PM) Kitchen Assistant (11AM-1PM on Sat or Sun) Substitute Volunteer (As Needed) COMMUNITY STORES/FOOD PANTRY Putting Away Merchandise Sorting/Bagging Groceries (8:30AM-11AM Sat. prior to pantry days) Assist on Donation Dock Distributing Groceries (8:30AM-12PM 2 nd &4 th Wed only) Clothes Sorting and Hanging General Cleaning Front Desk Special Projects SUPPORTIVE HOUSING PROGRAMS Light Cleaning Provide/Donate a Fixed Meal Special Events Event Committees Event Preparation/Execution Fundraising ST. VINCENT DE PAUL ADMINISTRATION Office/Clerical Answering Phones Data Entry Mailings/Labeling 5:30AM-8AM 8AM-10AM 10AM-11AM 11AM-12PM 12PM-1PM 1PM-2PM 2PM-3PM 3PM-4PM 4PM-5PM 5PM-6PM 6PM-7PM 7PM-9PM Other: (specify) AVAILABILITY: Monday Tuesday Wednesday Thursday Friday Saturday Sunday How often would you like to volunteer? Once Weekly Bi-Weekly Monthly Quarterly As Needed 4

CODE OF ETHICS FOR VOLUNTEERS Society of St. Vincent de Paul District Council of Dayton 124 W. Apple St Dayton, OH 45402 937-222-7349 1. I will be conscious of the fact that everything I do, directly or indirectly, has the potential to reflect upon St. Vincent de Paul as a whole. I will hold myself to the highest possible standard of conduct reflective of the work that I do, always striving to avoid even the appearance of impropriety. 2. I will recognize the worth, dignity and uniqueness of all persons, and will at all times treat clients, customers, staff, and fellow volunteers with respect, regardless of race, color, sex, sexual orientation, age, religion, national origin, marital status, political belief, mental or physical disability, military status, status as a veteran or any types of discrimination based on personal characteristics, conditions or status. 3. I will at all times clearly distinguish between statements made by me as a private individual and statements representing St. Vincent de Paul and/or statements that could be mistakenly interpreted as representing St. Vincent de Paul. 4. I will at all times conduct myself in a professional manner while in public places and particularly at times when customers, clients, staff, and/or supporters of St. Vincent de Paul are present. 5. I will at no time aid or abet a client and/or anyone else in any form of illegal activity, or participate in any illegal activity that would directly or indirectly reflect adversely on the agency s integrity, or expose the organization to any negative publicity. I will never knowingly contribute to enabling a client s irresponsible behavior, or put my own safety or the safety of others at risk. 6. I will at all times avoid relationships or commitments that conflict or may conflict with the interests of St. Vincent de Paul. 7. I will avoid any romantic attachments and/or sexual relationships with clients, customers, and/or residents, whether they are temporary or long-term participants in an agency program or activity. 8. I will at no time transport a client or resident for any reason. 9. I understand that, as a St. Vincent de Paul volunteer, I am not permitted to invite clients or residents into my home for any reason, nor am I permitted to spend the night in a client or resident s quarters. 10. I will actively work to expand choices and opportunities for all people with special regard for disadvantaged or oppressed groups of people. 11. I will avoid exploitation of professional relationships for personal gain. 5

I will at no time accept monetary gifts from customers, clients, or residents without prior approval of the program manager. 12. I will not purchase from or sell any merchandise or services to clients, customers, or residents, nor will I engage in their hire for personal projects. 13. I will at no time engage in activities designed to proselytize or convert a customer, client, or resident to a particular religion, belief or church. 14. I will actively work to prevent practices that are inhumane or discriminatory against any person or group of persons. 15. I will respect the privacy of customers, clients, and residents and hold in confidence all information obtained in the course of providing professional services, to include: a. I will not take photos or video recordings of clients, residents, staff or other volunteers at any time, without written permission from the Administrative Offices of St. Vincent de Paul. b. I will not disclose confidential information regarding any facet of the program of its participants without prior approval from senior management; c. I will not acknowledge to anyone outside the agency that an individual is a participant, client, customer, resident or recipient of any agency program or services; d. I will not discuss or reveal confidential information regarding fellow volunteers or St. Vincent de Paul employees; and e. I will make no statements to the media. 16. I will at no time use profanity, vulgarity, obscenities, or discriminatory slurs against or involving customers, clients, residents, staff, or fellow volunteers. 17. I will not be under the influence of drugs and/or alcohol while volunteering or while acting as a representative, actual or perceived, of the agency. PLEASE KEEP THIS COPY FOR YOUR RECORDS 6