Volunteer Application

First Name *:

Last Name *:

Date of Birth *:

Gender *:

Race *:

Ethnicity *:

Street *:

City *:

State *:

Zip *:

Email *:

Phone:

Mobile *:

Emergency Contact Name *:

Emergency Contact Phone *:

Emergency Contact Relationship *:

Do You Speak Spanish?:

School Status *:

Program Town(s) of Interest *:

Availability *:

Work Experience/Profession:

What is your main motivation for volunteering?:

If you have not yet graduated High School, please fill out the following fields. Adults can skip to the end of the form.

High School:

Other High School:

Current Grade / Year:

Graduation Year:

Guardian Information

Guardian 1 First Name:

Guardian 1 Last Name:

Guardian 1 Home Phone:

Guardian 1 Mobile Phone:

Guardian 1 Work Phone:

Guardian 1 Email:

Guardian 1 Address:

Guardian 1 is Emergency Contact:

Guardian 2 First Name:

Guardian 2 Last Name:

Guardian 2 Mobile Phone:

Guardian 2 Home Phone:

Guardian 2 Work Phone:

Guardian 2 Email:

Guardian 2 Address:

Guardian 2 is Emergency Contact:

For volunteers under 18 years of age, we will contact your guardian for consent.

Our Policy: It is the policy of this organization to provide equal opportunities without regard to race, color, religion, national origin, gender, sexual preference, age, or disability.

I acknowledge that I have applied to volunteer my services in the programs of Neighbors Link, a non-profit community center. I acknowledge that I am not an employee of Neighbors Link. I understand that while Neighbors Link takes seriously the need to provide a safe workplace for staff and volunteers, Neighbors Link cannot insulate me from unforeseen circumstances which may cause me harm. I assume the normal risks of such volunteer service and I agree not to hold Neighbors Link responsible for such risks, which may include personal injury or death, and property damage or theft. In consideration of the opportunity to volunteer with Neighbors Link, I agree on my own behalf and on the behalf of my representatives, assigns, heirs, and kin to waive, discharge, release and further agree not to sue Neighbors Link (or its officers, directors, employees, agents or volunteers) from any and all responsibility, liability, claims or actions arising out of or in any way related to my volunteer services at Neighbors Link. I further consent to the unrestricted use of any photographs, recordings, interviews, videotapes, motion pictures or similar visual recording of me taken in connection with my volunteer services. If an emergency should arise, I understand my responsibility to immediately notify the onsite program facilitator and/or Neighbors Link staff and follow their direction. I have carefully read the Volunteer Policies of Neighbors Link. I am aware that the Federal Volunteer Protection Act of 1997 is available for review at www.gpo.gov/fdsys/pkg/PLAW-105publ19/pdf/PLAW-105publ19.pdf

Confidentiality Agreement Volunteers

By submitting this application, you acknowledge that you have read and agree to be bound to the aforementioned Confidentiality Agreement above.