Please complete this application form if you are interested in becoming a Horizons volunteer. Once you complete the form, click the Continue button at the bottom.


Contact Information

Please use full names in this section. We use this information to run your background check. Thank you! 



Emergency Contact Information

Please enter the information of a trusted contact for you in the event of an emergency.



Demographic Information

You may optionally provide the following information. It will not be used as a selection or exclusion criteria for volunteer opportunities. This data allows Horizons to ensure that our volunteer base reflects the diverse nature of our clients and our community.




How would you like to help?

Please use the checkboxes to indicate the volunteer opportunities you're interested in



Availability

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



Volunteer/Work Experience

Tell us about your work experience and any past volunteer activities you have enjoyed.



Background Check

It is the policy of Horizons, A Family Service Alliance to provide a safe, helping environment and service for our clients. Therefore, the Agency requires that criminal, child abuse and dependent adult abuse record checks and any other background information be completed on all who are considered for employment, internship, or volunteering at Horizons. Please complete the information below by checking the appropriate statement and adding additional information required.

Please note that charges that have been deferred will be visible in a criminal background history report as will non-convictions.



Media Release

I consent to Horizons or its assignee to be allowed to use my name or likenesses of me, including photographs, video, and/or quotations of my remarks for public distribution, including published articles and promotional pieces.



Driver's License

I declare that I have a valid Iowa Driver’s License and that I maintain liability insurance for operating a vehicle.



Our Policies

Non Discrimination:

It is the policy of this organization to provide equal opportunity without regard to race, color, religion, national origin, sexual orientation, gender identity, age, or disability. It is the policy of Horizons, A Family Service Alliance, to make every reasonable effort to provide a safe environment for our clients and volunteers.

Non-Solicitation:

The promotion of an individual person, their business/company or religion they represent is prohibited. The use of volunteering to directly or indirectly solicit or prospect for financial gain is strictly prohibited. This includes announcements of fee or free networking opportunities that ultimately lead to a solicitation. We do not allow solicitation of our clients at any time. You are fully responsible for your conduct and could be asked not to return to the agency.

Confidentiality

I understand that I may be in a position to view or overhear personal or medical information regarding some of the agency’s clients. In keeping with the professional standards and ethics of Horizons, I will consider all client information to be strictly confidential and, therefore, not to be shared with or discussed with any unauthorized person, either inside or outside the agency.



Volunteer Agreement and Waiver

I have agreed to serve as a volunteer for the Horizons, A Family Service Alliance, and I recognize that my volunteer participation is a privilege afforded to me by the Horizons, A Family Service Alliance. I fully understand, appreciate and assume all of the risks associated with my volunteer duties. In exchange for my participation, I hereby agree to the following:
1. I voluntarily waive, release and hold harmless the Horizons, A Family Service Alliance, its elected and appointed officials, officers, employees, agents and other volunteers from any and all claims, causes of action and damages for bodily injury or death that I may suffer as a result of, or in any manner connected with, directly or indirectly, my participation as a Horizons, A Family Service Alliance volunteer when such bodily injury or death is the result of my own negligent or intentional acts or omissions or those of another volunteer. I understand that this waiver and release precludes my right to recovery of damages in the event I am injured in the course of performing my volunteer duties.
2. I shall defend, hold harmless and indemnify the Horizons, A Family Service Alliance, its elected and appointed officials, officers, employees, agents and other volunteers, from and against all damages, claims, liabilities, causes of action, judgments, settlements, costs and expenses (including, but not limited to, reasonable expert witness and attorney fees) that may at any time arise or be claimed by any person as a result of bodily injury, death or property damage, or as a result of any other claim or cause of action of any nature whatsoever, arising from or in any manner connected with, directly or indirectly, my negligent or intentional acts or omissions in performing my volunteer duties.
I have read, fully understand and agree to the assumption of risk, waiver, release, hold harmless and indemnification terms set forth above.

By submitting this application, I affirm that the facts set forth in this application are true and complete to the best of my knowledge.