Volunteer Application Form

Please complete this application form if you are interested in becoming a Camp Pendleton Volunteer Program volunteer. Once you complete the form, click the submit button at the bottom.

Name and address

First name:	*
Last name:	*
Title:	*
Street 1:	*
Street 2:
Street 3:
City:	*
State:	* Zip: *
Home phone:	* OK to call me here
Work phone:	OK to call me here
Cell phone:	OK to call me here
Email address:	*
Password:	*
Confirm password:	*

Demographic Information
Please provide the following information. It is used only to help us get a better idea of the demographic make-up of our volunteers.

Date of birth:	*
Gender:	*
Education:	*

Availability
Please indicate the days times you are usually available to volunteer.

	Sun	Mon	Tue	Wed	Thu	Fri	Sat
From:
To:

Times

Assignment

Email Preferences
We like to keep volunteers informed of important news, schedules, and volunteer opportunities by email, however will not send you any email you prefer not to receive. Use the checkboxes below to select the kinds of email you would like to receive from us.

What kinds of email would you like to receive?

	All Volunteer Opportunities Details for new volunteer opportunities: On-going, One-time Events, etc.
	Youth Opportunities Details for new Youth volunteer opportunities: On-going, One-time, etc.
	Volunteer Program Updates Details for Volunteer Program changes & additions.
	Base Volunteer Event Invites Electronic invitations for annual Volunteer Recognition Ceremony & other Volunteer Program specific events.

Miracosta Service Learning Students *ONLY*
Please identify how many hours you need to complete for your class and the date you need complete your hours by.

Active Duty *ONLY*
Please complete the following information.

Employer name:
Street 1:
City:
State:
Zip:
Work phone:

Volunteer Agreement/Confidentiality Agreement
1. I expressly agree that my services are being provided as a volunteer intern and that I will not be an employee of the United States Government or any instrumentality thereof, except for certain purposes relating to compensation for injuries occurring during the performance of approved volunteer intern services and liability for tort claims as specified in 10 U.S. Code Section 1588(d)(2).

2. I expressly agree that I am neither entitled to nor expect any present or future salary, wages or other benefits for these voluntary intern services.

3. I agree that I am bound by the laws and regulations applicable to voluntary service providers and agree to participate in any training required by the installation or unit in order for me to perform the voluntary services that I am offering.

4. I agree to observe all MCCS and Marine Corps rules and regulations at all times, and that I may be required to submit to an official background check, if required.

5. I agree not to divulge any information obtained in the course of my volunteer service to unauthorized persons and not to publish or otherwise make public any information regarding persons who have received services. I recognize that unauthorized release of confidential information may make me subject to civil action under provisions of the Welfare and Institutions Code.

6. I understand that this volunteer assignment may be cancelled for any reason, with one day's written notice by either MCCS or me.

I Agree

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