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Volunteer Registration

Volunteer Registration Form
  1. First Name(*)
    Please let us know your first name.
  2. Last Name(*)
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  3. Last 4 digits Social Security(*)
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  4. Address(*)
    Please exclude special characters
  5. City(*)
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  6. State(*)
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  7. Zip Code(*)
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  8. County(*)
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  9. Phone(*)
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  10. Your Email(*)
    Please let us know your email address.
  11. Date of Birth(*)
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  12. Gender(*)
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  13. Ethnicity(*)







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  14. Date you are available to start volunteering(*)
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  15. When are you available for volunteer work(*)



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  16. Occupation(*)
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  17. Limitations(*)
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  18. Employer (optional)
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  19. Emergency Contact Info
  20. First Name(*)
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  21. Last Name(*)
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  22. Phone(*)
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  23. Relationship(*)
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  24. Community Service Section
  25. Resource Center policy prohibits volunteer service from anyone convicted of a crime against a child and/or a violent offense.
  26. Have you been convicted of a misdemeanor or felony?(*)
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  27. If yes, reference your offense and date when occurred.
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  28. Are you required by a court to perform community service work?
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  29. How many hours
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  30. Date hours to be completed by
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  31. The following must be provided before any community service work can be performed.
  32. Courts Contact
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  33. First Name
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  34. Last Name
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  35. Phone
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  36. Fax
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  37. Case Number
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  38. Education and Experience
  39. Check the following areas where you ALREADY HAVE training or experience.
  40. Experience(*)
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  41. Indicate up to 4 areas you find of interest.
  42. Volunteer Areas(*)












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  43. Other
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  44. Confidentiality Policy
  45. Due to the nature of information available through Resource Center or any of its agencies (Food Pantry, Clinic, and Community Center), it is imperative that volunteers understand and are committed to confidentiality.

    Volunteers who fail to comply with this policy are subject to counseling and possible termination. In addition, civil and criminal penalties exist under the Communicable Disease Prevention Act and other laws for violating confidentiality.

    CORE OF CONFIDENTIALITY

    What goes on at the agency is not discussed outside the agency.

    If in doubt about the need for confidentiality, don’t share the information.

    All volunteers must comply with the following:

    • Information about Resource Center staff, volunteers, clients and use of client services is confidential and shall not be shared.
    • Volunteers must not attempt to access information not directly related to the specific RC work area or project.
    • If you encounter an RC client outside the agency, volunteers must not interact with the client unless the client first acknowledges you.
    • Under no circumstances are volunteers to acknowledge to anyone that they know a client from the agency.
    • Volunteers must not discuss or distribute project- or program-related information without the express written consent of the executive director or other appropriate authority.
  46. Confirmation(*)
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  47. Volunteer Agreement
  48. Volunteers of Resource Center:
    • Abide by the rules and regulations of the Center as defined in the volunteer training manual with regards to skills and requirements for the volunteer program.
    • Arrive on time.
    • Give advance notice for an absence from volunteer duties.
    • Provide notice before resigning volunteer duties.
    • Participate in periodic performance reviews and training updates.
    • Follow the Center’s dress code.
    • Respect and follow the Center’s confidentiality policy.
    • Should a grievance occur, follow the Center’s grievance policy to a resolution.
    • Uphold the Center’s policy to ensure a safe and drug-free environment.
    • Sign in for only time actually worked.

    You may from us:

    • Volunteers will be treated with dignity and respect and accorded equal status to that given to paid staff.
    • Value and recognize volunteer service.
    • Provide a safe and comfortable work environment
    Specific prohibitions

    In order to maintain a safe and drug free environment for provision of services, any volunteer who is found to commit verbal abuse to others, threatening physical abuse to others, possess illegal substances or paraphernalia, possess a firearm or other lethal weapon on Resource Center property or otherwise act in an unacceptable manner will be excluded from volunteering until, in the agency’s judgment, the behavior has ceased.

  49. Confirmation(*)
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  50. Captcha(*)
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