Please complete this application form if you are interested in becoming a Hennepin County volunteer. Once you complete the form, click the "Continue" button at the end of the application. Fields marked with an asterisk (*) are required.


Name and address


Contact

Please provide either a current phone number or email address. We cannot process your application without a current phone number or emaill address.



Demographic Information

You must be 12 years or older to volunteer at Hennepin County.




Emergency Contact


Preferences

Choose only one.



Work/Volunteer History

Enter current employer and/or relevant work history here.



Special Skills


Education

Enter relevant education details here



Hennepin County Volunteer

If you are currently serving or previously served as a Hennepin County volunteer please indicate the department in which you currently serve or have served.



Hennepin County Employee


Criminal History

Some volunteer positions with Hennepin County require criminal history information. All volunteers need to complete the following questions. You will be notified if further information is required. Have you been convicted of a felony within the last seven years? (Answering “yes” does not mean you are disqualified from all volunteer positions.)



Your Rights As A Subject of Data

Hennepin County provides equal access to volunteer opportunities without regard to race, color, creed, religion, age, gender (except when gender is a Bona Fide Occupational Qualification), disability, marital status, sexual orientation, public assistance or national origin. If you believe you have been discriminated against, contact the Human Resources Department, A-400 Government Center, Minneapolis, MN 55487, 612.348.2163.


In accordance with the Minnesota Government Data Practices Act, we are informing you of your rights as a subject of data. The data you give us about yourself is needed to identify you and assist in determining your suitability for the volunteer position(s) for which you are applying.


Race, gender, and age group data are used in summary form to monitor protected class employment and to meet federal, state, and local reporting requirements and affirmative action efforts. Date of birth is used for above noted data reporting purposes and minimum age-related assignments.


As stated above, race, gender and age group information are optional. If you withhold other data we may not consider your volunteer application. If you do provide the data and you are subsequently selected as a volunteer, the data you have given us will become part of your volunteer record.


The data we collect about you is classified as either Public or Private. Public means that it is available to anyone who asks to see it. Private means that the data is only available to the person the information is about and to staff who must see it in the normal course of conducting county business, as discussed further below, and as otherwise provided for by current or future law. Data collected on, or in response to, this volunteer application that is classified Private may be shared with county personnel who determine your suitability and ranking for the position(s) for which you apply.


The following data which Hennepin County collects on you as an applicant are public:

Name Position Title Job history




Informed Consent

I am requesting to be allowed to participate as a volunteer for the Department of Environmental Services.


Volunteers participate in the Department of Environment and Energy's programs (hereinafter the “Program”) at their own risk. I understand that Program activities may involve certain inherent risks, including the risk of physical injury. I currently have no known physical condition that would impair my ability to participate in the Program, including, but not limited to, engaging in vigorous physical activities. I have carefully considered the risks involved and voluntarily agree to participate in the Program.


I understand it is in my best interest to thoroughly list all training and experience. All statements made on this application are true, complete and correct to the best of my knowledge and belief. I understand these statements are subject to verification. My misrepresentation or falsification of information or material omissions may result in rejection of my current application submitted or subsequent dismissal from volunteer service if discovered at a later date. Falsification or omission may also result in my not being considered for future volunteer service opportunities.


My submission of this application is my consent for Hennepin County and its agents to conduct all necessary checks needed to meet the requirements for this position and my agreement to supply all required information. Final offers of volunteer service will be conditional pending results of reference checks and criminal conviction/background check as applicable to the position. My failure to provide information will disqualify me as an applicant for this position.


Please review your application to ensure that you have completed all sections.


I have carefully read and fully understand the above information.