Please complete this application form if you are interested in becoming a KIC-IT (Kids In Crisis Intervention Team) volunteer. Once you complete the form, click the submit button at the bottom. Within 24-48 hours after you have submitted your application Chelsea Fountain, Case Manager will contact you to explain next steps.


Name and address


Demographic Information

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



Previous Experience


Volunteer Interests

Please check each of the volunteer opportunites that interest you the most. These can be changed at a later date.



Availability

Volunteer opportunities are available during our normal business hours of 10:00am-5:00pm. Additional volunteers are needed from 5:00pm-6:00pm, Tuesday and Thursday while we serve our community meal.


Please provide your availability. Are you flexible? Do you prefer during the day? Do you prefer Tuesday ONLY or Thursday ONLY? Would you like to volunteer BOTH Tuesday and Thursday? Please include how often you would like to volunteer (every week, a couple of times a month, other). This is only used as a guide. You can change your availability at any



Set-Up Password


Email 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.



Emergency Contact


References

Please include two references.



Limited Criminal History & Sex Offender Registry

I hereby authorize Kids in Crisis Intervention Team to request and receive a limited criminal history subject under the following conditions:


1. The purpose for disclosure is to verify eligibility as volunteers will be working with a vulnerable population (youth).

2. I understand that I have a right to request that I view the results of these checks.

3. If you are denied placement as a result of the information from the background check a different setting will be explored.

4. By checking "I agree" below you understand that this consent is valid as long as you are a KIC-­IT volunteer.



Volunteer Agreement:

The Volunteer:


• I agree to volunteer in a manner that is safe for me, other volunteers, staff, and KIC-IT clients.

• I agree to participate in orientation and training programs as required.

• I agree to take part in any safety training that is required.

• I agree to accept guidance & direction for my duties, responsibilities, and supervision from KIC-IT staff while I am volunteering.

• I agree to a criminal background check and sex offender background check

• I agree to have an assessment of my performance completed by my supervising KIC-IT staff.

• I agree to follow a non-discriminatory, harassment-free, drug and tobacco free environment.

• I agree to the dismissal procedure for my volunteer opportunity which are as followed:


Step 1: A meeting will be held with volunteer and Executive Director to discuss problems with performance of the volunteer. During the meeting the volunteer and Executive Director will outline improvements needed, more direction, and further guidance as needed.


Step 2: If problem continues, a second meeting will be held and a timeline will be added as a probationary period during which the volunteers performance must improve.


Step 3: If probationary period ends with no improvement, the volunteer will be notified with a written dismissal of their volunteer opportunity. (All above meetings will be documented by Executive Director)


KIC-IT agrees to:


• Provide appropriate orientation and training.

• Provide guidance, direction, and advice for the volunteers duties, responsibilities, and supervision

• Provide an environment that volunteers can ask questions, concerns and/or complaints.

• Encourage and recognize volunteer efforts and achievements.

• Provide feedback to volunteers through the assessment of performance.

• Provide information on organizational changes that are relevant to the volunteer.

• Provide a safe and friendly volunteer environment.


FRATERNIZATION

While KIC-IT does not want to interfere with off-duty and personal conduct of its volunteers and employees, certain types of off duty conduct and relationships may interfere with the agency’s legitimate business interests. To prevent unwarranted sexual harassment claims,confidentiality lapses, uncomfortable working relationships, morale problems among other employees, and even the appearance of impropriety, managers & supervisors of KIC-IT are strictly prohibited from engaging in consensual romantic or sexual relationships with managers,supervisors or any employee or clients of KIC-IT.


DRUG FREE WORKPLACE

Possession or use of alcohol or other controlled substances during work or volunteer hours is prohibited and grounds for disciplinary action, including discharge. It is the KIC-IT policy to strictly forbid the possession, unauthorized distribution, sale, transfer, manufacture or use of alcohol, controlled substances or illegal drugs in the KIC-IT site. Reporting for work or volunteering while intoxicated or impaired by alcohol or drugs is forbidden. Any employee arrested for drug or alcohol abuse must report the matter to the supervisor/ president within 5 days of his/her conviction date. All offices and works paces will be “smoke free”.



Confidentiality, HIPAA & Privacy Practices

KIC-IT respects the privacy of clients and shall hold in confidence all information obtained in the course of professional services in accordance with state laws. KIC-IT personnel shall not share with others those confidences revealed by persons served, without their consent, except for compelling professional reasons such as danger to self or others. KIC-IT shall follow all applicable state and federal privacy laws (HIPAA) in order to ensure the private information of people served.


KIC-IT personnel shall fully inform persons served about the limits of confidentiality, the purposes for which information is obtained, and how it may be used. Personnel shall afford persons served reasonable access to any official records concerning them. When providing persons served with access to records, KIC-IT staff shall take due care to protect the confidences of others contained in those records. Personnel shall obtain informed consent of persons served before photographing, taping, recording, or revealing any identifying information.



Volunteer Agreement

By clicking "I Agree" below I am agreeing:


1. I have read & agree to abide by the expectations set forth in the KIC-IT Volunteer Agreement.

2. I agree the above information is accurate and answered to the best of my ability.

3. I agree KIC-IT can use my photo & identification through various mediums to promote the KIC-IT program.

4. I agree KIC-IT can use my information to run a limited criminal history and sex offender background check.