SEATTLE ICO
Volunteer Application
Updated 6/1/2017
Please complete the following application and return it by AUGUST 21st, 2017.
Mail to: Seattle ICO, c/o Alisha Migliore 1423 E Olive St., Seattle 98122
Email application or questions to:
This page should be retained for your records.
Requirements for becoming a Fully Certified Seattle ICO Volunteer:
●participate in the annual late-summer new leader training weekend on September 9th10th($45 fee)
●maintain current membership in the Sierra Club (membership rates vary—standard rate is ~$25)
●successfully complete required background checks (References, Screenings)
●become certified in First Aid and CPR (within three months of completing training)
●complete the Child Abuse Recognition and Prevention self assessment
As a Seattle ICO Volunteer you will be expected to
●become an active leader on one of Seattle ICO’s established elementary, middle, or high school teams
●commit to participating in Seattle ICO for a full academic year (September to June)
●participate and attend a minimum of four monthly school team outings per academic year
●contribute to Seattle ICO’s organizational development needs, which may includeparticipating in publicity efforts, helping with gear/equipment care, or sharing your skills and experience in other ways
●participate in at least one fundraising or community outreach activity per year
●help Seattle ICO become an even stronger and more active program by sharing your enthusiasm for getting young people outdoors, and having fun working with other volunteer leaders serving our community’s children and youth
After receiving your application, a member of the Seattle ICO new leader recruitment team will review your information, contact your references, and contact you if needed. If you have any questions, please email or call (206) 947-9185
Training Weekend: All new leaders must attend the mandatory New Leader Training Weekend held the weekend after Labor Day in September. This training is designed to introduce you to the Seattle ICO organization, to educate you on the policies and procedures of the Sierra Club and ICO and to provide you with the skills necessary to make our outings safe, educational and fun for all participants.
Seattle ICO 2017 New Leader Training will be the weekend of September 9th10th at the Washington Alpine Club Lodge – Guye Cabin – at Snoqualmie Pass. Participants are asked to contribute $45 per person to cover the cost of all meals, materials and lodging. Additional information about the New Leader Training weekend and directions to Guye Cabin will be sent to you once your application has been approved.
Application Checklist Name:______
(please include this page with your application)
Included in this application:
○A – Personal Information
○B – Experience and Interest
○C – Skills Summary
○D – References and background Check
○E – ICO Code of Ethics
○F – Sierra Club Outings Volunteer Agreement
Along with completing and signing the information included in sections A - F, applicants should attach legible copies of their:
○Driver’s License
○Passport or another form of identification (employee card, Social Security card)
○CPR Card (if taken within the past three years). If you do not have a current CPR class, applicants should sign up to attend a class taught by the Seattle Fire Department or some other certified trainer. It is preferred that applicants complete the CPR class before attending training.
○First Aid (if taken within the past three years). Applicants can wait and take a First Aid class within the first three months following the training weekend. If the First Aid class is not conducted by Seattle ICO or sponsored by the American Red Cross, it must be pre-approved by Seattle ICO. Seattle ICO will conduct one free First Aid class tailored to ICO in the late fall. The date will be announced during the weekend training (likely to be a Saturday or Sunday in early November). It is an all-day class.
A – Personal Information (please print carefully or type)
Thank you for your interest in being a volunteer in Seattle’s Inspiring Connections Outdoors program. It is our goal to match the skills and interests of our leader candidates with the groups we will be bringing on trips. We also want to ensure a safe environment for participants and leaders. Please take some time to print or type your detailed responses to the following questions. Feel free to attach extra pages where necessary.
Name: ______Phone: ______
Address: ______
Occupation: ______
Employer: ______
E-mail Address: ______
Date of Birth: ______
Driver’s License # ______Expiration Date: ______
Emergency Contacts: (name, phone #, address)
1) ______
2) ______
1. The Sierra Club has a liability insurance policy for individual ICO volunteers operating as volunteers of the Club. The policy requires that ICO leaders have active memberships in the Club. Applicants invited to become ICO leaders will be expected to be members of the Club at the time of the new leader training. Are you currently a Sierra Club Member? Yes______No______
If yes, my Sierra Club Membership # is ______Expiration Date ______
If no, I will become a member before attending the New Leader Training. Yes______No______
(You can sign up for Club membership at Membership rates start at $25 for individuals.)
2. Are you a certified leader with another Sierra Club entity? Yes______No______
If yes, please list: ______
3. How did you hear about Inspiring Connections Outdoors? What, if any, interaction have you had to date with ICO? (i.e. worked for a school/agency ICO serves, attended a meeting, volunteered for event, etc.) ______
4. Do you know anyone who volunteers with Seattle ICO? Yes______No______
If yes, then who & what agency? ______
5. Are you applying with another person (spouse/partner/friend)? Yes______No______
If yes, who? ______
6. Seattle ICO will try and place you with the age group or agency you may wish to work with, but in some cases this may not be possible. Is there a specific agency or age group that you wish to volunteer with? Why? ______
______
______
7. Are you in good physical health? Yes______No______
If no, list any conditions that might limit your active participation in ICO______
B - Experience and Interest
1. Identify previous or current volunteer experiences you have had as an adult that may be relevant to your roles as an ICO leader. Please include the name of the organization, the timeline of your commitment, and the roles you served.
2. Briefly describe previous experience you have had working with youth.
3. Seattle ICO needs to add volunteers who can combine their interests and skills in working with youth with the interests and skills needed to strengthen our dynamic organization. Please place a check next to the tasks you are willing to help ICO accomplish.
_____ Participate on the fundraising team
_____ Participate on the equipment locker team
_____ Help with the ICO website
_____ Represent ICO at regional and national training events
_____ Help organize future new leader training activities
_____ Help recruit new leaders from diverse ethnic backgrounds
_____ Help conduct first aid training
_____ Help with communications (newsletter, email, flyers)
_____ Participate in special fundraising events
C – SKILLS SUMMARY
Please circle the number that best represents your skill level with respect to each listed item. Make note of skills you would like to develop or acquire by placing an asterisk (*) beside the skill topic. If you don’t have skills in an area, then skip it.
0 = no experience
1 = comfortable participating
2 = proficient
3 = experienced as leader
1. Youth Experience
______Working with Youth (ages 8-12)
______Working with Teens (ages 13-14)
______Working with Teens (ages 15-18)
2. Environmental Education and Games
______Environmental Education with youth
______Outdoor games and activities with youth
3. Outdoor Activities
______Hiking
______Cross-country Skiing
______Canoeing
______Kayaking
______Backpacking
______Camping
______Orienteering
______Snowshoeing
______Rafting
______Environmental Education
______Other (List)
______
______
4. Organizational Skills
______Fundraising ______Equipment Maintenance
______Newsletter writing ______Conducting training activities with adults
______Community relations/Publicity ______Conducting training activities with youth
______First Aid/Medical______Website design
______Volunteer recruitment/Development ______Other ______
D - Reference and Background Check
1. Please provide contact information for three references (other than friends or relatives):
Name______Phone #______
Relationship______
Name______Phone #______
Relationship______
Name______Phone #______
Relationship______
2. ICO performs a background check on all potential leaders as part of its risk management program. The screening is self-administered and free of charge. Screening results are reviewed by the national Program Director according to Sierra Club policies, and a pass/fail result is sent to Seattle ICO. By signing this application, you are permitting Seattle ICO to initiate this background check.
Have you ever been arrested? (Exclude arrests involving traffic violations) Yes______No______
Do you object to ICO checking with appropriate public authorities (e.g., police, courts, Dept. of Motor Vehicles, etc.) for matters of public record regarding your background or history? Yes______No______
I certify that the information given herein is true and complete to the best of my knowledge. I hereby authorize the Sierra Club to investigate all statements contained in this application, contact individuals and/or organizational references, and furthermore authorize the release of personal information regarding me. This information is to be used only to determine my suitability for leadership with Inspiring Connections Outdoors. I understand that misrepresentation or omission of facts called for herein will be sufficient cause for termination of service.
Signature: ______ Date: ______
E - Inspiring Connections Outdoors Code of Ethics (All Certified Leaders must read and sign this document)
1.Smoking or use of tobacco products in the presence of youth during ICO outings is prohibited.
2.Using, possessing, or being under the influence of alcohol or illegal drugs during ICO outings will not be tolerated. Using or possessing any weapons (firearms, knives, etc.) during ICO outings is prohibited.
3.Volunteers will not abuse (verbally, physically, and sexually) participants or co-leaders in any way. Suspected abuse must be reported as outlined in the ICO Addendum of the Outings Leader Handbook, Section 4: Working With Youth, Child Abuse Education.
4.Volunteers will conduct themselves in a courteous and respectful manner, exhibit good sportsmanship, and provide positive role models for all youth. Volunteers must treat children of all ages, religions, and cultures with respect and consideration.
5.Volunteers must use positive techniques of guidance, including positive reinforcement and encouragement rather than competition, comparison, or criticism. Volunteers shall abstain from humiliating or frightening discipline techniques.
6.Two or more ICO volunteers must participate on each outing. If possible, both male and female leaders should be present during co-educational outings. Under no circumstance, except extreme emergency, may any volunteer be alone with a youth participant. Volunteers will refrain from intimate displays of affection towards others in the presence of children, parents, or other volunteers.
7.Volunteers must be free of physical and psychological conditions that might adversely affect children’s health, including fever, or contagious conditions.
8.Volunteers are prohibited from access, display, or possession of pornography on Sierra Club’s property, equipment, or on trips with children.
9.Volunteers will accept supervision and support from ICO staff, ICO certified leaders, and agency staff.
I have read the above statement, and agree to its terms. I understand that any violation of this statement may result in my termination as an ICO volunteer.
Signature: ______Date: ______
F - Sierra Club Outings Volunteer Agreement(ICO Leaders and Local Officers)
Thank you for volunteering to serve as a leader or local officer for the Sierra Club Inspiring Connections Outdoors (ICO) program. In order to serve in a volunteer leadership capacity in Sierra Club Inspiring Connections Outdoors, we need your agreement to the existing Sierra Club policy governing your status with respect to trips, ICO policies and standards.
First, in helping with the ICO program you are considered an Outing volunteer. You are not an employee of the Sierra Club or any of the Sierra Club’s chapters or subsidiary organizations. Since you are a volunteer and not an employee:
●You will not be paid wages or salary or any remuneration whatsoever for your volunteer services;
●You will not be entitled to any fringe benefits or other rights and privileges that may be afforded Sierra Club employees;
●You will not be entitled to state unemployment compensation, state disability compensation, social security or any similar governmental benefit, and accordingly no unemployment, disability, or social security contributions will be paid on your behalf; and
●You will not be covered by any workers’ compensation insurance. None of the above benefits or payments will be paid to you or on your behalf because you are a volunteer and not an employee.
Second, as a Sierra Club volunteer offering to serve on an Inspiring Connections Outdoors trip, you are free to terminate your relationship with the Inspiring Connections Outdoors program and the Sierra Club at any time. (We anticipate that you will give your local ICO group chairperson reasonable notice of any such termination so that alternate arrangements can be made, if necessary.) The Sierra Club enjoys the same right to terminate the volunteer relationship at any time, with or without cause, and may exercise these rights in its sole and exclusive discretion. Leadership is a privilege, not a right. In order to maintain the high standards of the Sierra Club and to continue to live up to the public expectation based upon its excellent reputation as a leader in the outdoor industry, leaders must meet criteria established by Sierra Club volunteer and staff management.
Third, Express Assumption of Risk. You understand, acknowledge and agree that the Inspiring Connections Outdoors trips for which you have volunteered may involve inherent risks of injury. You understand that Inspiring Connections Outdoors may require considerable physical activity, mental activity and stress, unusual itineraries and modes of transportation which will entail certain risks to your person. You acknowledge that illnesses and accidents, including serious illnesses and accidents causing severe physical injury, mental injury, and even death, could occur during any Inspiring Connections Outdoors, and that such accidents could take place in remote locations which lack adequate medical facilities and from which there is not access to emergency rescue personnel or facilities. You appreciate and understand the seriousness of these risks and having been informed of these risks, and with such appreciation, information and understanding, you freely and voluntarily and expressly and without reservation assume all such risks and agree that such risks are not the responsibility of the Sierra Club. [____ initial here]
Fourth, as a Sierra Club Outing volunteer, you must cooperate fully with any investigation of suspected child abuse. Failure to do so may be grounds for immediate termination.
Please print your name, sign and date this letter in the spaces provided below, indicating your understanding and receipt of this agreement, and return it to your local ICO group chairperson.By executing this agreement, I, the undersigned volunteer, do consent to myvolunteer status, to the policies and to the assumption of risk agreement set forth herein. This agreement will remain in effect until canceled in writing by one of the parties. Understood and Agreed to:
Print Name: ______SC Membership #:______
Address: ______
City, State, Zip: ______Phone#: ______
Signature: ______Date:______
G - InspiringConnectionsOutdoors supplemental information
(This information will not be considered in the approval of your application, but may be helpful in determining your team placement)
1. To the best of your ability, please indicate how long you hope to remain as a volunteer with ICO.
A. one year ______B. two years ______C. more than two years______
2. Is there anything that would limit your ability to attend the minimum of four trips per year? Yes____ No_____
If yes, please explain:
3. Although we typically use rental vehicles on our trips, at times ICO leaders elect to transport youth or other adults in their personal vehicles. Please check Yes or No where appropriate:
A. Are you over age 21 and have a valid driver’s license that would allow you to drive a rental vehicle? Yes_____No______
B. Do you own a car that you would be willing to transport youth in for trips? Yes______No______
C. If yes, what is the name of your car insurance company and policy number?______
D. Do you carry personal liability insurance on your car? Yes______No______
E. Do you carry personal property damage insurance on your car? Yes______No______
Please be advised that if you use your personal vehicle for ICO transportation, your personal insurance is the ONLY coverage. Read the Sierra Club’s policies and frequently asked questions on transportation at: (user ID: clubhouse password: explore)
Attach Photos copies /scans here:
○Driver’s License
○Passport or another form of identification (employee card, Social Security card)
○CPR Card (if previously certified)
○First Aid Card (if previously certified)
2017 Seattle ICO Application Page 1 of 106/1/2017