For agency use only: Govt. ID: _____________________Volunteer Application • June 9th, 2021
ContractVolunteer Application • June 14th, 2018
Name Date Street Address City, State, Zip Code Cell Phone: Home: Work: E-mail Address Spouse/ Partner Date of Birth (mm/dd) Optional: Employer / Occupation Retired yes/no Affiliations:Church, Organizations, Agencies Volunteer Experience
Level 2 and Level 3 Volunteers complete this application and the MCS Confidentiality Agreement.Volunteer Application • November 8th, 2019
Social Security Number for Level 3 Volunteers for background check: _ Please list the name(s) and grade(s) of your child(ren) attending MCS:
Volunteer ApplicationVolunteer Application • August 28th, 2018
PVEN Volunteer ApplicationVolunteer Application • September 7th, 2018
Last Name First Name Middle Initial Date of Birth Street Address City State Zip Code Home Phone Cell Phone Email Contact Preference
VOLUNTEER APPLICATIONVolunteer Application • February 26th, 2019
Volunteer Info:Volunteer Application • January 9th, 2021
Type: New Renewal ☐ ☐ Volunteer Appointment Form☐NON-USA CITIZENS ATTACH VISA ☐ ☐ State Oath/Patent Agreement ☐ ☐ Personal Data Form ☐ ☐ Volunteer Agreement ☐ ☐ Volunteer Expectation ☐ ☐ Confidentiality Agreement ☐ Child/Elder Abuse & Neglect Reporting Acknowledgement ☐ UCSD Information Systems Computer/Information Use and Security Statement ☐ UCSD Health Sciences Standards of Business Conduct Acknowledgement Statement ☐ Acknowledgement Receipt of Workers’ Compensation ☐ Acknowledgement Receipt ☐ HIPAA Module 1 (sign the last page) ☐ HIPAA Module 2 (sign the last 2 pages) ☐ UCSD PDS Emergency Contact ☐ UCSD PDS Photobook ☐ UCSD PDS MyPDS Registration ☐ Background Check
Emergency Contact Phone *** Attached Cruisin' Krewe Agreement must be signed & dated prior to consideration.Volunteer Application • July 20th, 2018
Following are the opportunities, locations, days and shifts available. Cruisin' The Coast will do its best to match you with your preference but may ask you to volunteer to meet needs of the event. Please mark your preferences.
Davis Medical CenterVolunteer Application • August 14th, 2017
Background Check: Each applicant will be subject to a background check. Permission to run this background verification is provided within application.
West Central Health District 2100 Comer AvenueVolunteer Application • March 6th, 2019
Volunteer ApplicationVolunteer Application • January 8th, 2016
Have you ever committed, been convicted of, pled guilty to, or pled nolo contendre to, a felony or misdemeanor? No Yes, Please explain
ContractVolunteer Application • December 19th, 2016
Thank you for your interest in becoming a Saint Agnes Medical Center Experience Advisor volunteer. Our Experience Advisors bring a unique perspective to the delivery of health care, and we embrace their input into our continuous improvement efforts around patient experience, safety, quality and education. All efforts are aimed at shaping a culture that embraces patients and the community as true partners in the delivery and environment of health care.
Franklin County Community Based Correctional Facility Volunteer ApplicationVolunteer Application • July 19th, 2022
which is offered on an evening and is approximately 2 hours in length? Yes Are you currently on parole, probation, or furlough? Yes
SPYA Volunteer Application 2021-22Volunteer Application • December 28th, 2021
VOLUNTEER APPLICATION 2023-24Volunteer Application • April 6th, 2023
Members of the Minutemen will be called up to serve in a variety of ways. This form allows us to do a background check and enlist help via email, Communiqué and
The ROCCVolunteer Application • September 11th, 2016
As a volunteer at The Recovery Oriented Campus Center, you are asked to maintain the privacy of others. Therefore anything that you see, hear, read, or already know about a Peer must be kept confidential. Please sign acknowledging your understanding and agreement to abide by this:
Volunteer ApplicationVolunteer Application • January 6th, 2022
Thank you for your interest in becoming a volunteer in our Volunteer Companion Program (VCP). Please use the guidelines below to ensure you provide us with the application requirements:
Office Use Only: Response Agreement, Release, and Waiver PA Criminal Record Check Child Abuse Record Check PA Verification/FBI Clearance Orientation Commitment Form Placement: _______________Volunteer Application • August 16th, 2016
List any professional, civic or other organization that you belong to that you consider relevant to your ability to perform this job:
Kennebunk Free Library Volunteer ApplicationVolunteer Application • October 27th, 2021
Confidentiality Agreement: I understand that it is the policy of the Kennebunk Free Library to protect the privacy of those who use the Library. I agree to hold all information about patrons, including per- sonal information, requests for information and records of materials they may have borrowed in com- plete confidence and to access this information only in the course of performing my volunteer assign- ments. In addition, I understand that a breach of confidentiality is grounds for dismissal from the Li- brary’s Volunteer Services Program.
TOWN CATS INC. JUNIOR VOLUNTEER APPLICATION FORMVolunteer Application • June 2nd, 2016
I, the undersigned, do hereby release Town Cats, Inc., its directors, officers, trustees, volunteers and representatives from liability to myself and/or my part for any damage, accident, or injury to person(s) or property incurred in relation to visiting the shelter or animals under the control of the organization.
VBS 2017 Volunteer ApplicationVolunteer Application • April 22nd, 2017
Today’s Date:Volunteer Application • July 30th, 2021
Simi Valley Friends of the Library’s bylaws state that booksellers/dealers cannot volunteer for our bookstore. By signing below, I acknowledge that I accept and understand this rule. Volunteers for Simi Valley Friends of the Library must also be current members. If not a current member, I agree to join Simi Valley Friends of the Library (or renew my membership) and, if applicable, am including my membership form and payment ($15.00). I agree to volunteer my services to the Simi Valley Friends of the Library beginning
Agreement and SignatureVolunteer Application • July 24th, 2024
BAD WEATHER SHELTER VOLUNTEER APPLICATIONVolunteer Application • September 29th, 2018
Volunteer ApplicationVolunteer Application • December 15th, 2015
LEGAL NAME DOBVolunteer Application • May 21st, 2019
Tell us why you are interested in being a Bike Club volunteer. Please include any bicycling experience or certifications you may have.
Volunteer Info:Volunteer Application • January 22nd, 2021
Type: New Renewal ☐ ☐ Volunteer Appointment Form☐NON-USA CITIZENS ATTACH VISA ☐ ☐ State Oath/Patent Agreement ☐ ☐ Personal Data Form ☐ ☐ Volunteer Agreement ☐ ☐ Volunteer Expectation ☐ ☐ Confidentiality Agreement ☐ Child/Elder Abuse & Neglect Reporting Acknowledgement ☐ UCSD Information Systems Computer/Information Use and Security Statement ☐ UCSD Health Sciences Standards of Business Conduct Acknowledgement Statement ☐ Acknowledgement Receipt of Workers’ Compensation ☐ Acknowledgement Receipt ☐ HIPAA Module 1 (sign the last page) ☐ HIPAA Module 2 (sign the last 2 pages) ☐ UCSD PDS Emergency Contact ☐ UCSD PDS Photobook ☐ UCSD PDS MyPDS Registration ☐ Background Check
IN CASE OF AN EMERGENCY, PLEASE NOTIFY:Volunteer Application • July 14th, 2011
On the chart below, please check any shifts for which you would be able to accept a volunteer assignment. This does not necessarily commit you to multiple assignments, but will help us in selection of placement options.
Volunteer Application for (2014)Volunteer Application • September 8th, 2021
Cruisin' The Coast 2024 October 6 - 13Volunteer Application • December 11th, 2023
Following are the opportunities, locations, days and shifts available. Cruisin' The Coast will do its best to match you with your preference but may ask you to volunteer to meet needs of the event. Please mark the location and time you wish to volunteer and we will do our best to put you there. Please do not mark more than one location during the same time frame. This will be your schedule unless we call and ask you to work elsewhere.
Date received: Resume/cover letter received □ Reference checked □ Education Session Date: Interview Date: On call □ Yes □ No Cultural/confidentiality agreement □ Area of volunteering:Volunteer Application • April 27th, 2016
Please include your resume and a short cover letter with your application. Applications can be returned via email to volunteering@inspirehealth.ca or to InspireHealth directly.
TB Verification Agreement AssignmentVolunteer Application • July 12th, 2018
Received: Interview: ¾ Vulnerable Sector Check ¾ Occupational Health Clearance ¾ Confidentiality Agreement ¾ Photo ID/parking badge ¾ Database Entry Volunteer Position: Start Date: End Date: Reason:Volunteer Application • November 21st, 2021
□Miss □Ms. □Mrs. □Mr.Name: Preferred Name: Contact Information:Address: City: Prov. Postal Code: Home Phone: Cell: E-Mail: Emergency Contact InformationName: Relationship: Phone Number: Languages Spoken□English □French □Other: Are you currently a student? ! Yes ! No□High school □College/University □Full Time □Part Time Reason for Volunteering at Kemptville District Hospital:! Academic Credit ! Explore Careers! Develop Skills ! Social Interaction! Help Others ! Personal Satisfaction! Show Appreciation for Help Received ! Community Involvement
Volunteer ApplicationVolunteer Application • September 14th, 2020
This agreement is intended to indicate the importance with which we treat our volunteers. The intent of the agreement is to assure you both of our appreciation for your services and to indicate our commitment to make your volunteer experience both productive and meaningful. You must be at least 12 years old or in 6th grade or older to be a volunteer.
