Volunteer Application Form (Union City Corps)

Thank you for your interest in volunteering for The Salvation Army in Union City. Once you complete the form, click the continue button at the bottom. Please note that an * indicates a required field.

General information

First name:

Last name:

Title:

Kind:

Individual Group

Group name:

# of Members:

Participation:

If your group will serve more than once, you will usually send...
The same volunteers each time
Different volunteers each time

Street 1:

Street 2:

City:

State:

* Zip: *

Preferred phone:

* OK to call me here

Work phone:

OK to call me here

Cell phone:

OK to call me here

Date of birth:

(year optional)

Gender:

Highest level of education attained:

Employer/School

Please list your current or most recent employer or if you are a student please list your current school, if applicable.

Employer/School:

Street 1:

Street 2:

City:

State:

Zip:

Emergency contact

In the event of an emergency who should we notify?

First name:

Last name:

Preferred phone:

Relationship:

Email

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.

Email address:

What kinds of email would you like to receive?

Electronic newsletters
Periodic electronic newsletters will provide information updating you on Salvation Army volunteer opportunities and events.

Volunteer opportunities
This e-mail will give all registered volunteers information on volunteer opportunities available at The Salvation Army. The notices you receive will be determined by where you live and your areas of interest.

Training announcements
This e-mail will give you information on up-coming training opportunities that may be needed for your volunteer assignment.

Schedule reminders

Skills and Experience

In which of these areas do you feel you have moderate to excellent skill? Check all that apply.

Availability

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

Sun

Mon

Tue

Wed

Thu

Fri

Sat

From:

To:

I would like to serve up to:

hours:

Why would you like to volunteer for us?

Briefly explain why you are interested in volunteering for The Salvation Army:

Assignment preference

Please choose which volunteer opportunities you are most interested in.

Felony conviction

Have you ever been convicted of a felony?

If you have been convicted of a felony, please explain the situation:

References

Please provide personal, professional or academic references. Please do not use family members as a reference.

1

2

First name:

Last name:

Preferred phone:

Email address:

Photo Release

I hereby give my permission to be photographed by a representative of The Salvation Army for the sole purpose of promotion of the services available at The Salvation Army. I also understand that I have the option at any time not to be photographed if I choose.

Photo release:

Agreement

The following are the terms of my volunteer service:

1. I understand that The Salvation Army is a religious and charitable organization that requires the assistance of volunteers in the conduct of its various spiritual and social service programs.

2. I undertake to perform services as a volunteer without compensation and that, in performing services, I acknowledge that I am not acting as an employee of The Salvation Army.

3. I understand that as a volunteer, should any accident occur, I may be covered for limited coverage of medical expenses under The Salvation Army liability insurance.

4. I hereby give my permission to be photographed or video recorded by a representative of The Salvation Army for the sole purpose of promotion of the services available at The Salvation Army. I also understand that I have the option at any time not to be photographed or video recorded if I choose.

5. I understand that as one of the largest charitable and service organizations in the world, The Salvation Army has been in existence since 1865 helping those in need without discrimination.

Statement of Volunteers for work with children

With the understanding that The Salvation Army will rely upon the information provided in considering my application for volunteering with or around children, that the foregoing information and following statements are true:

1. I have never used a name other than that provided.

2. I understand the essential duties of my position in connection with the working with children in the programs of The Salvation Army. I am able to perform those essential job duties with no accommodation except as follows:

3. I have never been accused of abuse of a child or of actual or attempted sexual molestation of a child, either in a program for minors or otherwise.

4. I have never been arrested as a result of a charge of child abuse or of actual or attempted sexual molestation of a child.

5. I have never been convicted of child abuse or a crime involving actual or attempted sexual molestation of a child.

6. I authorize my personal references provided to give to The Salvation Army any information they may have regarding my character and fitness for work with children. I release all such organizations and individuals from any liability that may result from their furnishing such information to The Salvation Army. I waive any right that I may have to inspect any records containing such information.

7. I am aware that The Salvation Army is a branch of the Christian Church and, in the event that my application is accepted, I agree that I will conduct myself in my volunteer work with or around children in a way which is consistent with the religious and charitable policies and principles of The Salvation Army.

8. Having provided the foregoing information and having affirmed the foregoing statements are true, I recognize that any false information or statements are punishable under the laws relating to perjury.

Nondisclosure Agreement for Social Services Personnel

A large part of the work of many Salvation Army Social Services personnel involves personal and private information. Such information either discussed or incorporated in written records or computer files must be treated confidentially. It is the property of The Salvation Army and is not to be released without proper authorization. What comes to you as part of your work is not to be discussed with other employees or anyone else, other than those to whom you are responsible in your work. Violation of this confidentiality provision shall be grounds for disciplinary action, up to and including immediate discharge.

People who seek assistance from The Salvation Army when they have special needs, which may range from fairly simple to painfully difficult, provide personal information. Their need for service and the help that can be given is determined through factual and personal information. For this process to be effective there must be trust that The Salvation Army will maintain such information from beneficiaries/clients in strict confidence.

The requirement of maintaining confidentiality extends to all Salvation Army officers, employees, and volunteers. The Salvation Army, its officers, employees and volunteers shall maintain all such confidential information, including whether a person is or has been a recipient of services, in compliance with Salvation Army procedures and will comply with all applicable state and federal statutes and regulations.

The requirement of confidentiality applies to The Salvation Army as an organization, not only to an individual service provider, since client information is normally shared internally for legitimate purposes of training, supervision, records accountability and expanded client service.

Requirements of confidentiality and how these are carried forward in The Salvation Army are addressed during the orientation of each new employee, advisory organization member, and other volunteers. As a general principle, no information about individuals receiving Salvation Army services will be disclosed outside of the organization except when informed written consent has been obtained from the service recipient or is ordered by a court of competent jurisdiction.

Requirements of The Salvation Army's Confidentiality Policy and individual agreement to comply:

1. I agree to not disclose the fact that an individual is or has been a participant in a Salvation Army social service or community service program to any individual or agency outside of The Salvation Army, except when the beneficiary/client has stated in writing and signed the official "Authorization for Release of Information Form" and then only to the extent necessary or as ordered by a court of competent jurisdiction.

2. I agree to not engage in unnecessary or inappropriate conversations regarding any beneficiary/client I serve and only discuss their affairs with other appropriate Salvation Army personnel and only in regard to the subjects necessary to meet the reporting needs of The Salvation Army and service needs of the beneficiary/client.

3. I agree to access, view, and/or print only the information that is necessary to perform my position requirements. I agree not to access, view or print any Salvation Army personnel records that are not relevant to my position and if any confidential information is provided or accessible, I will not discuss it with other employees or anyone else, other than those to whom I am responsible in my position.

4. I agree to place all written documents from or about beneficiaries/clients and any written documents about Salvation Army personnel in a secure place and to lock my computer terminal when leaving my desk area. Any personally identifiable information will be kept in a secure place and only accessed when required to perform my position requirements.

5. I agree to not share my Social Services Client Software username and password with any individual. In addition, if my username and password are needed by an authorized computer technician for services to my computer, I will personally enter this information as needed for services by the technician. I also agree to abide by the "Information Technology Acceptable Use Policy".

6. I understand that the records and related documents about beneficiaries/clients are the responsibility of The Salvation Army. Any request by a law enforcement agency or court, including subpoenas, must be served on an Officer or other authorized individual and who will respond as required by Salvation Army policy.

I understand and agree that submitting this application form does not automatically register me as a The Salvation Army volunteer, and that there may be certain clearances and qualifications I must meet, including the acceptance of established volunteer policies and procedures before I may begin volunteering.

I Agree