Please fill out this brief form to help with translation for the Disaster Relief Assistance for Immigrants. We welcome the valuable help of our Rotary Partners.
Someone will contact you within three business days.

Name and address


Language beside English fluently spoken


Availability


Release of Liability, Confidentiality and Media

"By signing this signature form I agree to following: RELEASE OF LIABILITY: I understand the risks present in volunteer duties and freely assume those risks and agree to release Catholic Charities, its officers, agents and employees from and against all claims for injury, loss, or danger to me/my child as a result of such duties.
PHOTOGRAPHIC RELEASE: I grant my permission for Catholic Charities to use photographs and/or videos containing my/my childs likeness. These photographs may be used for Catholic Charities programs publicity, newsletters, social media, marketing and development pieces, and for other promotional purposes.
Disaster Relief Assistance for Immigrants (DRAI) Confidentiality Agreement

This Confidentiality Agreement must be signed by any person conducting application intake, making eligibility determinations, access to confidential, sensitive, or personally identifying information (PII) of DRAI applicants and/or approved applicants.

I the volunteer applicant certify that I am providing services related to the Disaster Relief Assistance for Immigrants (DRAI) Project as an employee, independent contractor or volunteer providing services to __CATHOLIC CHARITIES OF SAN FRANCISCO.

I agree to use, protect and preserve personal and confidential applicant information in accordance with relevant state and federal laws and the terms and conditions of the Grantee’s Agreement. I further agree that a breach of confidentiality and privacy may result in disciplinary actions, up to and including termination of my employment or contract.

CIVIL RIGHTS: Volunteers may not discriminate on the basis of any individuals race, color, citizenship status, national origin, ancestry, gender, pregnancy, sexual orientation, gender identity or expression, genetic information, age, religion, creed, physical or mental disability, marital status, veteran status, political or religious affiliations, or any other characteristic protected by law (Protected Status).
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