Children’s Advocacy Center for Kaufman County

APPLICATION AND RELEASE

I do hereby affirm that all of the answers provided on my volunteer application are true.  I understand that the information in this application will be verified by Kaufman County Children’s Advocacy Center and that the inclusion of any false information or the omission of any requested information is cause for my immediate dismissal by Kaufman County Children’s Advocacy Center.  I hereby authorize Kaufman County Children’s Advocacy Center  to investigate my background (including checking my personal references, criminal history and records with Child Protective Services) as part of the screening process to determine my fitness / appropriateness as a potential volunteer.   I understand that not all applicants who apply to be a volunteer are chosen to participate in the program and that Kaufman County Children’s Advocacy Center reserves the right to deny an applicant into the volunteer program for any reason. 

I understand that the information requested in this application will be used only for the purpose of determining suitability as a Kaufman County Children’s Advocacy Center volunteer.  Further, I understand that after the successful completion of my training, it will be my goal to serve a minimum of one year in the Kaufman County Children’s Advocacy Center program.  If unforeseen circumstances prevent me from fulfilling this goal, I will notify the Executive Director with as much advance notice as possible.  I am aware of the sensitive and confidential nature of the official documents, reports and other material I will examine in my capacity as a volunteer.  I will discuss these matters only with those persons directly involved in the case, or who will be consulted for their professional knowledge and expertise.

I agree to inform Kaufman County Children’s Advocacy Center if any information in this application changes any time during my volunteer participation in any of the programs of the agency.

PERMISSION TO RELEASE PRIVATE INFORMATION

YES, you may release my home address and home phone number from my volunteer file.

CONFIDENTIALITY AGREEMENT

Any information observed in connection with employment/volunteering or serving on the board of directors with the Children’s Advocacy Center for Kaufman County (CACKC) is considered confidential. Confidential information includes the following: information about any client’s identity or that of his/her family, his/her seeking services at the CACKC or other location, what transpires at any meeting with the client or his/her family, any information gathered while working with the client or his/her family, and any personal information disclosed to you in your capacity as an employee/volunteer/board member for the CACKC.

 I will not violate the confidential relationships between the CACKC and its staff, volunteers, and participating and related agencies. I will not remove any written, typed, copied, e-mailed, or faxed documents/records/notes/files from the offices of CACKC without the express permission of Center staff.

I accept full responsibility for maintaining the confidential and private nature of all records and information. I understand that I am personally responsible and liable for any violation of this agreement.