Volunteer Application Form

Please complete this form if you are interested in becoming a City of Southlake volunteer. All applicants must be at least 12 years of age.

Once you complete this form, click the submit button at the bottom. Once submitted, you must visit our website: www.volunteersouthlake.com to complete the application process. If you are 17 years of age or older, please complete the volunteer background check form. If you are under 17, your parent or guardian must complete the Parental Consent Form.

We will notify you by email once your application has been received.

Please feel free to contact volunteer@ci.southlake.tx.us if you have any questions.

Name and Address

First name:

Last name:

Title:

Street 1:

Street 2:

City:

State:

* Zip: *

Cell phone:

* OK to call me here

School Name:

* Why would you like to volunteer?:

As part of court-ordered service

To give back to the community

To meet academic requirements

Only For Court-Ordered Community Service Applicant

Please specify: how many hours you need to serve, by when you need to complete these hours and your infraction. Thank you.

I would like to serve up to:

Demographic Information

Date of birth:

Gender:

T-Shirt size:

Group Affiliation:

Emergency Contact

First name:

Last name:

City:

State:

Cell phone:

Email address:

Relationship:

Assignment Preference

Please select your volunteer assignment preferences to help us better serve your needs. If you only have a few areas of interest you can select the same assignment multiple times.

* Assignment Preference:

1st choice:

2nd choice:

3rd choice:

Email Address & Password for VicNet

Enter your email address and a volunteer password below. NOTE: If you are filling this out for multiple family members; you will need a different email address for each person in order to utilize VicNet for everyone. Once your application has been accepted, you will be able to access your volunteer information and manage your schedule online through VicNet. You can access this portal by visiting www.volunteersouthlake.com and clicking on the VicNet link located under the Quick Links section on the right hand side of the page.

Email address:

Please enter a password that:

Is between 6 and 30 characters long

Password:

Confirm password:

Why Volunteer Southlake

One of Volunteer Southlake's core values is Quality Service. We strive to achieve this by recognizing your individuality and aim to provide you with a volunteer experience that meets your personal goals and remains mutually beneficial.

Please share what motivates you to volunteer with the City of Southlake:

How did you learn about us:

Examples: School requirement Earn a service award Meet new people Give back to the City One time event etc...

Consent:

By submitting this form, I acknowledge that I am volunteering my services for the City of Southlake. I acknowledge that my participation is completely voluntary and is being undertaken without promise or expectation of compensation. I am aware that while participating in any volunteer activities, I may be exposed to personal injury or damage to my property as a result of my activities, the activities of other persons or the conditions under which my volunteer services are performed.

With full knowledge and understanding, I accept any and all risks of damage, injury illness, or death and I release and discharge the City of Southlake, its officers, directors, and employees, from any claims for damages or injury and all liability arising out of my participation as a volunteer. This release, waiver, indemnification, and assumption of risk does not waive my right, if any, to seek eligible worker’s compensation for volunteer services if allowed by the City’s “Worker’s Compensation Declarations Page,” or other coverage available under the City’s general liability policy.

I have carefully read this release and fully understand its contents. I understand the above mentioned release of liability and I freely and voluntarily accept the terms. I further state that I am in proper condition for participating in volunteer events and I agree to abide by the rules established by the Volunteer Southlake Program.

Volunteering is a privilege; while you are working as a volunteer, you represent the City of Southlake. You are expected to conduct yourself in a courteous and professional manner with coworkers and citizens at all times. While it is our goal to support and retain all volunteers, volunteers are subject to dismissal or termination as a result of their actions or inactions. Volunteers who are no longer able to perform an assignment will be directed back to the Volunteer Office for discussion and possible reassignment.

I Agree

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