When complete click the submit button at the bottom of the application form!
Contact Information
*Name:
*Address:
*City:
*State:
*Zip:
*Phone No.:
In case of emergency contact:
Name:
Phone:
Are you under 18 years of age?
Yes No if so, date of birth:
Volunteer Interests
GENERAL: Office Help Fundraising Work/Training Programs Computer Training Public Relations Arts Programs Maintenance Companion for Group-home Residents
Other:
*Some programs require a commitment for entire session, generally 4-10 weeks. You must provide your own transportation to off-site programs.
RECREATION: Youth Teen Adults Arts Swimming Sports/Fitness Special Olympics Social/Community Trips
When are you available to volunteer?: Weekdays Weekday Evenings Weekends Weekend Evenings
If you will be receiving academic or community service credit, please describe your requirements::
Education
NAME
COURSE-DEGREE
High School
College
Graduate School
Employment History
Dates
Name, Address & Phone # of Employer
From (Month & Year): To (Month & Year):
Employer Name Employer Address Employer City/State/Zip Employer Phone
Describe your principal duties or responsibilities:
Title or Position Held:
References
Name, Address & Phone #
How long have you known this person?
Name Occupation Address City/State/Zip Phone
VOLUNTEER AGREEMENT I, the undersigned, represent and warrant that, to the best of my knowledge and belief, I am physically and mentally able to participate as a volunteer in EMARC programs. I agree to provide my own transportation to and from all programs and to notify a program supervisor immediately if I am unable to attend a program. With the submission of this form I certify that all information is a true and complete statement of the facts and answers required herein without omission. EMARC may contact all previous employers, schools, and references for full information except as I have stated otherwise on this form. By this form, I hereby authorize and direct employers, schools, and references, named above to give any information regarding my employment or education. If selected, I give my permission to include my name and/or picture in all EMARC promotional material, newspapers, T.V., radio, brochures, videos, etc. If a medical emergency should arise during participation in any EMARC program and I am not able to give my consent, for whatever reason, I authorize the organizers to take whatever measures are necessary and which it deems advisable to protect my health and well being, including but not limited to first aid, ambulance transport, and/or hospitalization. I for myself, my heirs, executors and administrators, waive and release any and all claims for damages I may have against the sponsors, organizers and any individuals associated with the event, their successors and assigns and will hold them harmless for any and all injuries suffered in connection with EMARC. I have read and fully understand the provisions of the above release. I understand that, through my signature of this release form, I am agreeing to the above provisions on my own behalf or on behalf of my child. ******* If you are over the age of 18, you will be required to complete a Criminal Offender Record Information (CORI) and a Disabled Person Protection Commission (DPPC) check. All volunteer positions are dependent on the return of these checks. Please note: these forms can take a few weeks to process, we appreciate your patience!
VOLUNTEER AGREEMENT
Digital Signature:
You must sign if you wish to be considered for volunteer positions! Thank you!
Parent/Guardian Signature:
Required if under 18 years of age.
*CLICK SUBMIT BUTTON TO ENTER APPLICATION WHEN FINISHED*
User Name:
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