Please complete this application if you are over 18 years old and are interested in becoming a committed individual Ronald McDonald House Charities of North Central Florida volunteer. Once you complete the form, click the submit button at the bottom.

Contact Information

Please enter information as it appears on your legal identification card.

First name:

Last name:

Title:

Nickname:

Street 1:

Street 2:

City:

State:

* Zip: *

Preferred phone:

Email address:

Are you currently a student?:

Yes

Is this service a requirement/mandatory:

Yes

Where did you find out about this opportunity?

Demographic Information

The following information is used to verify background checks, as well as to help us get a better idea of the demographic make-up of our volunteers.

Date of birth:

* (year optional)

Pronouns:

Ethnicity:

Are you bilingual?:

Yes

If you are bilingual, please indicate the language(s) you know and specify if you can read, write, and/or speak and on what level (beginner, intermediate, or fluent).

Volunteer Experience

Briefly describe any previous volunteer experience, including if/when/where you volunteered for a RMHC chapter.

Professional Experience

Briefly describe relevant work experience and indicate your skills that you can use with excellence, and enjoy. Even if you are retired, please describe your skills and/or interests.

Volunteer Goals

Please tell us why you are seeking to volunteer with RMHCNCF at this time.

Why do you want to volunteer at RMHCNCF?

Availability

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

Criminal Background History

Have you ever been convicted, pleaded "nolo contrende" or had adjudication withheld for any crime or offense other than a minor traffic violation. If Yes, please include details such as date, location, charge, etc.

RMHCNCF, in order to undertake reasonable efforts to protect the safety of its guest families, requires all volunteer applicants, age 18 and older to 1) go through a background check process and 2)produce their legal identification at orientation. This process does not however, guarantee the personal safety of any temporary resident, guest or staff member.

DECLINE: You have the right to decline to have the background check performed. However, if you do decline the background check, we will have no choice but to deny your request to volunteer at RMHCNCF.

FAIL: Individuals will be denied who have been convicted of violent crimes, crimes against children, sexually related offenses, and other serious repeat convictions that may affect the safety of the RMHCNCF community.

PASS: Individuals who pass the background check may be permitted to access our facility.

Volunteer Position Preferences

Please rank your top three choices of open volunteer positions. Please note: Unlisted volunteer opportunities are full until further notice.

Assignment Preference:

1st choice:

2nd choice:

3rd choice:

Is this service part of a mandatory requirement? If yes, please explain.

Emergency Contact Information

In the event of an emergency, whom should we notify? YOU MUST PROVIDE AT LEAST ONE DAYTIME PHONE NUMBER FOR YOUR EMERGENCY CONTACT.

Employer name:

First name:

Last name:

Title:

Other phone:

Preferred phone:

Other phone:

Email address:

Relationship:

Agreement

I certify that the information listed above is accurate, and understand that any falsification, misrepresentation, or omission may disqualify me from volunteering at RMHCNCF; or if already volunteering, then it will subject me to immediate dismissal from RMHCNCF volunteer service.

I understand that, while RMHCNCF will obtain criminal history background information on family guests and volunteers, it cannot and does not guarantee the personal safety of any temporary resident, guest, visitor, volunteer or staff member.

I certify that I am 18 years or older and have completed this form on behalf of myself, and not for other members of my party.

I understand and agree that submitting this application form does not automatically register me as a RMHCNCF volunteer and that there may be certain requirements I must meet, e.g., attending an interview and orientation, purchasing a uniform shirt and accepting established volunteer policies and procedures.

Per our Infectious Disease Control Precautions and Healthy House Rules: If volunteering, I certify that I am free from contagious diseases and/or conditions.

Ronald McDonald House Charities® (RMHC®): Grant, Assignment, Release and Waiver

I/We hereby grant to Ronald McDonald House Charities, its affiliates, subsidiaries, franchises, advertising and promotional agencies, and their agents representatives, any of its Chapter organizations (defined as an entity having the right to Ronald McDonald House Charities, Ronald McDonald House, Ronald McDonald Family Room, and/or Ronald McDonald Care Mobile, or other trademarks for charitable purposes) (collectively "RMHC") and McDonald's Corporation, its affiliates, subsidiaries, franchises, advertising and promotional agencies, and their agents and representatives (collectively "McDonald's"), the irrevocable, unrestricted worldwide right to use, publish, display, broadcast, edit, modify and distribute materials bearing my/our name, voice, image, likeness and/or any other identifiable representation of myself/ourselves (collectively "My Likeness".) These materials may appear in any form, style, color or medium whatsoever now known or later developed (including, without limitation, photographs, videotapes, films, sound recordings, software, drawings, prints, broadcast, internet and electronic media.) McDonald's use of My Likeness will be limited to use involving raising awareness of or for support of RMHC.

I/We agree that all materials containing My Likeness (including, without limitation, all negatives, plates and masters of any photographs, files, prints or tapes) shall be and remain the sole and exclusive property of RMHC and/or McDonald's and I/we hereby assign any right I/we may have acquired in or to such material to RMHC and/or McDonald's. I/we hereby release and forever discharge RMHC and/or McDonald's from any and all claims, liabilities and damages relating to the use of My Likeness. I/we hereby waive any right I/we may have to inspect or approve the finished materials or any part or element thereof that incorporates My Likeness.

I/we have agreed to the above in consideration of the opportunity given to me by RMHC and/or McDonald's to appear in these materials. I/we acknowledge that I/we have fully read and understand this document and that I/we have had any questions regarding its effect or the meaning of its terms answered to my/our satisfaction. I/we certify that I/we am/are at least 18 years of age, unless this document is also signed by my/our parent or legal guardian.

Confidentiality Agreement

I understand that any information regarding our families, donors, Board of Directors and staff members at the Ronald McDonald House or the Family Room is confidential.

I understand that this information is confidential under the Florida Statutes as well as other State and Federal regulations and is not to be shared without approval of the Executive Director. If a violation of this policy is discovered it could result in immediate dismissal.

I Agree