VOLUNTEER APPLICATION
Name:Address: / Phone Number: (h)
(c)
(w)
Email: / Date of Birth:
Social Security Number:
A copy of your Driver’s License or Student ID is required.
Name and Address of Employer:Position:______
Supervisor:
Employer Phone Number: / If Student, Name and Address of School:
Age and Grade:
Parent(s) Names and Phone Number:
1.______
2.
Emergency Contact Name and Phone Number:
2 Personal References Required (Name and Phone Number)
1.______
2.
How did you hear about us?______
Check off areas of volunteering that you are interested in:
___ Provide hospitality at host congregation ____ Provide a cooked meal to the host site
___ Work on Events Committee ____Volunteer in IHN office
VOLUNTEER CONTRACT
As an IHN Volunteer, I agree to the following terms and conditions:
Liability Release:
I,______, understand and agree that neither Interfaith Hospitality Network of Hunterdon County, nor any employee or volunteer associated with the agency is responsible for accidents, illness or injuries that may be sustained by me or any member of my family during my volunteer assignment.______
Signature Date
Confidentiality Agreement:
I, ______, understand and agree that I will not divulge information regarding the clients to anyone that is of a personal nature, as during the course of my volunteer assignment, a client may disclose certain personal information OR the volunteer coordinator or IHN staff may disclose necessary information in regard to safety/health issues.
______
Signature Date
Permission for Photographs:
I, ______, understand and agree that during a volunteer assignment, photographs may be taken and I give permission to use my photograph in IHN-related publications, to include newsletters, mailings, brochures, marketing materials and website.
______
Signature Date
Background Check:
I, ______, understand and agree that I may be subject to a random background check to determine if there any ongoing criminal charges, which would preclude me to work with families, specifically, children.
______
Signature Date
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