Please complete this application form if you are interested in becoming a CPCD Head Start volunteer. Once you complete the form, click the Continue button at the bottom. In-person orientations and background checks are required for all direct service (i.e., classroom) volunteers. The volunteer department staff will be in contact with you soon regarding the next steps. Thank you for your interest in volunteering with CPCD!


Name and address


Demographic Information

The following information is used only to help us get a better idea of the demographic make-up of our volunteers.


Referrals

How did you hear about CPCD...giving children a head start.


Affiliations

Are you currently affiliated with any of the following groups?


Project Preference

At CPCD we have a variety of volunteer opportunities. Tell us what your preferences are.


Skills & Experience


Language

Please indicate any language where you might be able to assist us in communicating with parents/guardians. Fluency is not required, but you should be proficient enough to carry on a conversation. Check all that apply.


Availability & Site Preference

Please indicate the days and times you are available to volunteer as well as your site preference.


Volunteer Interview

Let us know when would be a good time to schedule an in-person interview at our office, preferably before orientation. In-person interviews are required for ALL volunteers. Please indicate a date and time that would work for you.


References

List 2 personal or professional references that can tell us why you'll make a great CPCD volunteer!


Emergency Contact Information

In case of an emergency, who should we contact?


Contact Preferences

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.


CPCD Agreement

I understand and acknowledge that I am a volunteer of CPCD and not an employee or independent contractor. In this regard, I have no expectations of receiving compensation of any kind, future employment or employment benefits in exchange for or in connection with my services as a volunteer. I also understand that I am not covered by worker's compensation, unemployment, heath and other insurance provided to employees.

I agree to accept a position as a volunteer for CPCD and in so doing agree to comply with all policies, rules and regulations established. I understand failure to do so may result in my immediate termination as a volunteer.

I understand and agree that CPCD may use photos and videos taken of me in public relations materials. I hereby release ownership and rights to all photos and videos of me.

I understand that CPCD may terminate the volunteer relationship at any time, with or without prior notice, and for any or no reason. I certify the information I have given in this application is true.

I agree to keep information about CPCD children and families confidential, and to refer pertinent information to appropriate staff members only.