St. Vincent de Paul Volunteer Application

Please complete this application form if you are interested in becoming a St. Vincent de Paul Society of Lane County volunteer. Once you complete the form, click the Continue button at the bottom.

Basic Information

Please enter your preferred name in the first and last name boxes. If your legal name is different from your preferred name, enter your legal name in the "legal name" box.

First name:

Last name:

Middle initial:

Legal name (if different from above):

Street 1:

Street 2:

City:

State:

Zip: *

Primary phone:

Cell phone:

Email address:

Date of birth:

Languages spoken other than English:

Why are you interested in volunteering?

Please provide skills, experience, interests, or background you feel may be helpful or relevant to placing you in a beneficial volunteer opportunity.

Areas of Interest

Please list any types of volunteer work you would prefer and/or specific locations where you are interested in volunteering.

Required Service Hours

Please let us know if you are volunteering to fulfill any required community service hours. If not, select "no" for both questions.

If you answer "yes" to either question, please include the following information in the comment box below:

*Name of organization/program

*Number of hours needed

*By what date hours are needed

Court-appointed:

Other group or program (school, etc.):

Emergency Contact

First name:

Last name:

Home phone:

Cell phone:

Email address:

Relationship:

Background

The following questions are part of the process to help provide a safe and secure environment for our clients as well as you. All information is held strictly confidential by SVdP staff.

Please indicate whether you have ever personally experienced any of the following. A criminal background check may be obtained to verify this information; the final question asks whether you have any objections to us running a background check.

Statement of Release

I, the undersigned, hereby release St. Vincent de Paul Society of Lane County, Inc. (SVdP) from all liabilities in connection with any tasks performed as a volunteer and give permission to include my photograph in any of the agency's publications. I authorize SVdP to enter my name and contact information into their mailing list so that I can receive their publications.

By checking the "I agree" box below, I understand that a criminal background check may be obtained to verify the information I have provided on this application (applicable only to volunteers over the age of 18). I understand that in the event of an accident or injury while volunteering for SVdP, my health and vehicle insurance is primary.

Volunteers and prospective volunteers are expected to adhere to the same confidentiality standards as SVdP staff. Confidentiality includes disclosure of information about sexual orientation, religion, disability, race, color, age, creed, or personal history. Information regarding yourself, clients, staff, and other volunteers is not information that should be discussed with others within the agency or elsewhere.

I hereby authorize St. Vincent de Paul Society of Lane County, Inc. to verify all information contained in this application with any references to disclose any and all information to SVdP. I release all such persons from liability that may result of arise from the collection of all such evaluations or information or its consideration of my application.

I Agree

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