Volunteer Confidentiality Agreement. As a volunteer with Easter Seals Florida, Inc. you may have access to information of a highly sensitive and confidential nature. This information may be contained in conversation, company records, correspondence and other similar documents. As a volunteer of Easter Seals Florida, you are in a position of trust and you have an obligation to this organization, our clients, and our contributors, to see that the confidentiality of this information is strictly maintained and protected. Unauthorized use or disclosure, even if inadvertent, compromises both you and Easter Seals and seriously erodes confidence. Information regarding Easter Seals, our clients, or contributors is considered confidential and proprietary. Unless you have received written approval from the President of Easter Seals Florida, you may not disclose, duplicate or use this information except as required in the performance of your volunteer duties with Easter Seals Florida. I acknowledge that I have read the information above regarding confidentiality and understand that any unauthorized release or carelessness in the handling of this confidential information is considered a breach of confidentiality. I further understand that any breach of confidentiality could be grounds for immediate dismissal. Signature of Volunteer Date Signature of Staff Witness Date Corporate Compliance Code of Conduct Below you will find a copy of Easter Seals Florida, Inc. Corporate Compliance Code of Conduct. Each volunteer is required to read and sign the Code of Conduct Agreement, which certifies that you understand and agree to adhere to the outlined standards of conduct.
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Volunteer Confidentiality Agreement. As a volunteer with Easter Seals Florida, Inc. you may have access to information of a highly sensitive and confidential nature. This information may be contained in conversation, company records, correspondence and other similar documents. As a volunteer of Easter Seals Florida, you are in a position of trust and you have an obligation to this organization, our clients, and our contributors, to see that the confidentiality of this information is strictly maintained and protected. Unauthorized use or disclosure, even if inadvertent, compromises both you and Easter Seals and seriously erodes confidence. Information regarding Easter Seals, our clients, or contributors is considered confidential and proprietary. Unless you have received written approval from the President of Easter Seals Florida, you may not disclose, duplicate or use this information except as required in the performance of your volunteer duties with Easter Seals Florida. I acknowledge that I have read the information above regarding confidentiality and understand that any unauthorized release or carelessness in the handling of this confidential information is considered a breach of confidentiality. I further understand that any breach of confidentiality could be grounds for immediate dismissal. Signature of Volunteer Date Signature of Staff Witness Date Corporate Compliance Code of Conduct Below you will find a copy of Easter Seals Florida, Inc. Corporate Compliance Code of Conduct. Each volunteer is required to read and sign the Code of Conduct Agreement, which certifies that you understand and agree to adhere to the outlined standards of conduct.. Easter Seals Florida, Inc. CORPORATE COMPLIANCE CODE OF CONDUCT AGREEMENT The Corporate Compliance Program defines the standards of conduct expected of Easter Seals Florida, Inc. employees and volunteers. It provides guidance on how to resolve questions regarding legal and ethical issues, and establishes a reporting mechanism for possible violations. This standard is hereby known as the Code of Conduct (CODE). The CODE imposes requirements that are often more exacting than those mandated by law, reflecting the organization’s goal of conducting oneself with the highest level of integrity. The willingness of each employee and volunteer to raise ethical and legal concerns is essential. Ultimately, the responsibility for ethical behavior rests with each person’s exercise of independent judgment. I do hereby attest that I am in receipt of, and have read and understand our Corporate Compliance Code of Conduct. Further, I understand my duties and responsibilities related to the CODE and agree to comply. Signature Date Printed Name Easterseals Volunteer Dress Code Policy The designed uniform for all volunteers is outlined below: SHIRTS Volunteers may choose to purchase Easterseals t-shirts, but it is not required. Shirts must be clean and free of wrinkles. Shirts can be tucked in or out. If shirts are not tucked in, they can fit comfortable and loosely but must not be largely oversized and hang to knee level. No Tank-Tops, Spaghetti Straps, Halter Tops, Midriff Showing, etc. PANTS Jeans, slacks, long skirts and shorts are all acceptable forms of dress. Pants, jeans, slacks, cannot be torn, dirty or dragging the ground or have frayed edges. No low waist pants or skirts. Skirts have to be past the knee and should preferably be at mid-calf or ankle length. Shorts must be fingertip length (no exceptions). FOOTWEAR The most accepted form is sneakers or tennis shoes. According to Health Dept. regulations volunteers are not to wear open toe or open heel shoes. This is for the safety of the volunteer. OVERALL APPEARANCE Volunteers must arrive clean and free of body odor. Heavy perfumes are not allowed due to sensitivity of the member’s allergies and asthma. Hair may be done based on personal style as long as it looks professional and appears to be neat and combed, no hats. Nail length should not impede job performance, and should be length appropriate for the safety of our members. Large or dangling jewelry should not be worn. No visible tattoos and/or piercings. I agree to follow the above outlined dress code policies, and understand that if I do not comply with the above requirements, I will be subject to early dismissal. Volunteer Signature Date ADULT MEDIA RELEASE I hereby consent that any narratives, depictions, pictures, film, photographs, audio-visual or sound recordings or testimonials of me made by Easter Seals Florida or its respective employees and agents may be used by Easter Seals Florida, and those acting with its permission, for the purpose of illustration, broadcast, or testimonial in connection with any work of Easter Seals Florida and that these materials may be released to the general public. I assign to Easter Seals Florida all of my rights to these materials. I understand that these materials made by Easter Seals Florida, its employees and agents are owned by Easter Seals Florida and that they may copyright them. I will allow Easter Seals Florida, their respective employees and agents, and those acting with Easter Seals Florida's permission, to use my protected health information, as defined under 45 C.F.R. 164.501, for the purpose of illustration, broadcast, or testimonial in connection with the work of Easter Seals Florida and to release this information to the general public. I understand that these materials may be published on Easter Seals Florida's network of Web sites and this may disclose my personal and protected health information online. Easter Seals Florida does not need to submit these materials to me for further approval. I understand that these materials may be modified and that Easter Seals Florida may decide not to use them. I acknowledge that the rights described above are granted to Easter Seals Florida on an unlimited basis without any compensation or payment being made for any current or future use. I understand that this authorization is voluntary and that Easter Seals Florida will not condition any treatment or funding to me on the completion of this authorization. I also understand that I may revoke my consent to allow Easter Seals Florida to release my protected health information if the information has not already been disclosed. To revoke my consent, I must notify Easter Seals Florida in writing by sending my revocation to _0000 Xxxxxx Xxx. _Winter Park, FL 32792 . I understand and agree that once Easter Seals Florida, its respective employees and agents, and those acting with its permission, disclose my protected health information as contemplated by this release, this information is subject to re-disclosure and may no longer be protected by the Health Insurance Portability and Accountability Act of 1996. This release and authorization expires three years from the date of my signature below. I certify that I am over the age of 18 years old. I have read this release and authorization before signing below, and I fully understand its contents. Signature of Adult or Parent/Guardian Witness for Easter Seals Florida Printed Name of Adult or Parent/Guardian Date Date
Appears in 1 contract
Samples: Hold Harmless Agreement
Volunteer Confidentiality Agreement. As a volunteer with Easter Seals Florida, Inc. you may have access to information of a highly sensitive and confidential nature. This information may be contained in conversation, company records, correspondence and other similar documents. As a volunteer of Easter Seals Florida, you are in a position of trust and you have an obligation to this organization, our clients, and our contributors, to see that the confidentiality of this information is strictly maintained and protected. Unauthorized use or disclosure, even if inadvertent, compromises both you and Easter Seals and seriously erodes confidence. Information regarding Easter Seals, our clients, or contributors is considered confidential and proprietary. Unless you have received written approval from the President of Easter Seals Florida, you may not disclose, duplicate or use this information except as required in the performance of your volunteer duties with Easter Seals Florida. I acknowledge that I have read the information above regarding confidentiality and understand that any unauthorized release or carelessness in the handling of this confidential information is considered a breach of confidentiality. I further understand that any breach of confidentiality could be grounds for immediate dismissal. Signature of Volunteer Date Signature of Staff Witness Date Corporate Compliance Code of Conduct Below you will find a copy of Easter Seals Florida, Inc. Corporate Compliance Code of Conduct. Each volunteer is required to read and sign the Code of Conduct Agreement, which certifies that you understand and agree to adhere to the outlined standards of conduct. Easter Seals Florida, Inc. CORPORATE COMPLIANCE CODE OF CONDUCT AGREEMENT The Corporate Compliance Program defines the standards of conduct expected of Easter Seals Florida, Inc. employees and volunteers. It provides guidance on how to resolve questions regarding legal and ethical issues, and establishes a reporting mechanism for possible violations. This standard is hereby known as the Code of Conduct (CODE). The CODE imposes requirements that are often more exacting than those mandated by law, reflecting the organization’s goal of conducting oneself with the highest level of integrity. The willingness of each employee and volunteer to raise ethical and legal concerns is essential. Ultimately, the responsibility for ethical behavior rests with each person’s exercise of independent judgment. I do hereby attest that I am in receipt of, and have read and understand our Corporate Compliance Code of Conduct. Further, I understand my duties and responsibilities related to the CODE and agree to comply. Signature Date Printed Name Easterseals Volunteer Dress Code Policy The designed uniform for all volunteers is outlined below: SHIRTS Volunteers may choose to purchase Easterseals t-shirts, but it is not required. Shirts must be clean and free of wrinkles. Shirts can be tucked in or out. If shirts are not tucked in, they can fit comfortable and loosely but must not be largely oversized and hang to knee level. No Tank-Tops, Spaghetti Straps, Halter Tops, Midriff Showing, etc. PANTS Jeans, slacks, long skirts and shorts are all acceptable forms of dress. Pants, jeans, slacks, cannot be torn, dirty or dragging the ground or have frayed edges. No low waist pants or skirts. Skirts have to be past the knee and should preferably be at mid-calf or ankle length. Shorts must be fingertip length (no exceptions). FOOTWEAR The most accepted form is sneakers or tennis shoes. According to Health Dept. regulations volunteers are not to wear open toe or open heel shoes. This is for the safety of the volunteer. OVERALL APPEARANCE Volunteers must arrive clean and free of body odor. Heavy perfumes are not allowed due to sensitivity of the member’s allergies and asthma. Hair may be done based on personal style as long as it looks professional and appears to be neat and combed, no hats. Nail length should not impede job performance, and should be length appropriate for the safety of our members. Large or dangling jewelry should not be worn. No visible tattoos and/or piercings. I agree to follow the above outlined dress code policies, and understand that if I do not comply with the above requirements, I will be subject to early dismissal. Volunteer Signature Date ADULT MEDIA RELEASE I hereby consent that any narratives, depictions, pictures, film, photographs, audio-visual or sound recordings or testimonials of me made by Easter Seals Florida or its respective employees and agents may be used by Easter Seals Florida, and those acting with its permission, for the purpose of illustration, broadcast, or testimonial in connection with any work of Easter Seals Florida and that these materials may be released to the general public. I assign to Easter Seals Florida all of my rights to these materials. I understand that these materials made by Easter Seals Florida, its employees and agents are owned by Easter Seals Florida and that they may copyright them. I will allow Easter Seals Florida, their respective employees and agents, and those acting with Easter Seals Florida's permission, to use my protected health information, as defined under 45 C.F.R. 164.501, for the purpose of illustration, broadcast, or testimonial in connection with the work of Easter Seals Florida and to release this information to the general public. I understand that these materials may be published on Easter Seals Florida's network of Web sites and this may disclose my personal and protected health information online. Easter Seals Florida does not need to submit these materials to me for further approval. I understand that these materials may be modified and that Easter Seals Florida may decide not to use them. I acknowledge that the rights described above are granted to Easter Seals Florida on an unlimited basis without any compensation or payment being made for any current or future use. I understand that this authorization is voluntary and that Easter Seals Florida will not condition any treatment or funding to me on the completion of this authorization. I also understand that I may revoke my consent to allow Easter Seals Florida to release my protected health information if the information has not already been disclosed. To revoke my consent, I must notify Easter Seals Florida in writing by sending my revocation to _0000 Xxxxxx Xxx. _Winter Park, FL 32792 . I understand and agree that once Easter Seals Florida, its respective employees and agents, and those acting with its permission, disclose my protected health information as contemplated by this release, this information is subject to re-disclosure and may no longer be protected by the Health Insurance Portability and Accountability Act of 1996. This release and authorization expires three years from the date of my signature below. I certify that I am over the age of 18 years old. I have read this release and authorization before signing below, and I fully understand its contents. Signature of Adult or Parent/Guardian Witness for Easter Seals Florida Printed Name of Adult or Parent/Guardian Date Date Address EASTER SEALS FLORIDA, INC. A 501(C)3 ORGANIZATION REQUEST FOR LOCAL LAW ENFORCEMENT CHECK FOR VOLUNTEERS This form is to be filled out ONLY if the individual volunteering exceeds 10 hours per month. TO: County Sheriff's Department ADDRESS: Pursuant to Chapter 435, F.S., we request a local records check on the applicant listed below: Last Name First Name Middle Name Date of Birth Race Sex Social Security #______________________________________________ Please document the findings on this employee and return the information to: Name of Facility: Address: Easter Seals Florida Inc. 0000 Xxxxxx Xxx Winter Park, FL 32792 Please Fax results to: 000-000-0000 REQUESTED BY: Name and Title: Date Rev 9/12 EASTER SEALS FLORIDA, INC. LIVE SCAN INFORMATION FORM This form is to be completed ONLY if the individual volunteering exceeds 10 hours per month. Please complete all of the information below and attach a check for $60.50 (or $51.00 for Southwest Florida) so that the appointment for the Live Scan Fingerprinting can be made.If you’d like to go to a location other than one close to home (i.e. work) please enter an alternate zip code. Location/Service Code (Official use only): ________________________ PLEASE PRINT LEGIBLY First Name: Middle Name: Last Name: Street Address: City, State, Zip Code: Alternate Zip Code (if desired):_________________________________ ______________ ___ _________ _
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Samples: Hold Harmless Agreement
