Please complete this application form to become a volunteer. Once you complete the form, click the Continue button at the bottom.


Name and address


Demographic Information


Emergency Contact Information


Please note:

If you were convicted for a crime against a child, sexual assault or domestic violence, you cannot do your community service at Laramie Interfaith.



Confidentiality, Harassment and Sexual Harassment

1. I agree to maintain client and donor confidentiality while performing my duties as a volunteer, intern, employee, or board member of Laramie Interfaith.

Maintaining client and donor confidentiality generally means not discussing client or donor information seen or heard while performing my duties at Laramie Interfaith. Such Information should not be shared with anyone outside the Interfaith office, and any discussion with other volunteers, employees, or board members should be limited to the information required to serve our clients or to maintain data needed by Interfaith.

Do not discuss a client or donor when the information can be overheard by anyone not needing to know the information. When describing examples of cases, whether in public meetings or in private conversations, take care not to provide specific details that might identify a client or donor.

If a person calls, writes, emails, or comes to the office requesting information about a client and/ or donor, refer the request to the Executive Director. The client/ donor information can only be provided if the client/ donor signed an Authorization to Furnish Information Form, which authorizes that person to receive such information.

Maintain confidentiality for any person requesting medical, dental, mental health, or medication services so that Interfaith complies with the federal HIPAA (Health Insurance Portability and Accountability Act) requirements.

When in doubt about the need for confidentiality, err on the side of caution and keep the information to yourself.

If you have any questions or need clarification, please contact the Executive Director.


2 .I-GS will not tolerate harassment, including but not limited to belittling or rude behavior that creates an intimidating, threatening, hostile, or offensive environment.

Such behavior, when experienced or observed, should be reported immediately to the Executive Director or the employee’s immediate supervisor. If the supervisor or Executive Director is the party acting inappropriately, the employee may notify the Chair of the Board of Directors.

Harassment is a major violation of I-GS policy. Such behavior can lead to adverse action against the employee, Executive Director or volunteer and can result in disciplinary action, up to and including dismissal. If a client harasses any member of the I-GS community, I-GS may, in its sole discretion, refuse to provide services or assistance to the client.


3. Employees and volunteers, including Board members, are prohibited from sexually harassing any employees, board members, volunteers, or I-GS clients. Sexual harassment can interfere with work performance and create an intimidating, hostile, or offensive work environment. It can influence an employee’s or prospective employee’s career, salary, working conditions, responsibilities, duties, or other aspects of career development by creating explicit or implicit terms or conditions of an individual’s employment. I-GS does not tolerate any form of sexual harassment.

Sexual harassment includes, but is not limited to, sexual advances, verbal or physical conduct of a sexual nature, visual forms of a sexual nature (for example, signs, posters, and the like), or requests for sexual favors.

Such conduct, when experienced or observed, should be reported to Executive Director or the employee’s immediate supervisor. If the supervisor or Executive Director is the party acting inappropriately, the employee may notify the Chair of the Board of Directors.

Any intentional sexual harassment is considered to be a major violation of I-GS policy and can result in disciplinary action, up to and including dismissal.



Volunteer Contract

I have read and understand the Interfaith-Good Samaritan’s Confidentiality Policy, Sexual Harassment Policy, and Harassment Prevention Policy, and agree to follow the policies.


I agree that I have not been convicted of the aforementioned crimes.