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What days and times of the week are you available for volunteer assignments?
Which do you prefer?
Select all that apply.
Interests & Volunteer Experience
In which areas are you interested in volunteering?
DV 24-hour Hotline
On-Site Child Care
Court Advocacy for Domestic Violence
Domestic Violence Outreach Program
Domestic Violence Shelter
Select all that apply.
Please specify "other" area
Are you currently seeking volunteer hours in order to fulfill the requirements of a degree program or college class?
Please provide as an attachment to the Application your school’s volunteer requirements.
Max. file size: 512 MB.
Special Skills, Education, Qualifications, and Hobbies
Specialized education, training, skills, or hobbies
Domestic Violence 40 Hour Advocate Training
Foreign Language Skills
Domestic Violence 40 Hour Advocate Training Certificate
Max. file size: 512 MB.
Details About Specialized Education, Training, Skills, or Hobbies
Summarize your previous volunteer/work experience as it relates to your volunteer interests:
Person to Notify in Case of Emergency
Name of Emergency Contact
Phone for Emergency Contact
Relationship to You
I certify that all statements on this form are true and complete to the best of my knowledge. I hereby authorize the Child & Family Center to investigate any information contained in this application. I understand that as part of the final selection process, depending on the type of volunteer work, I may be required to pass a Tuberculosis test, physical, and/or fingerprinting and background check. I understand that false or misleading statements shall be sufficient grounds for disqualification from the volunteer program. Further, I understand that as a volunteer, I am offering my services of my own free will without any expectation of compensation, benefits, or insurance of any kind. I voluntarily agree to participate in this Volunteer Program. I hereby waive, release, and hold harmless from any liability or claims for damages for personal injury, including death, as well as from claims for property damage which may arise in connection with the above‐named activity, against the Child & Family Center or any of their employees. I hereby agree to pay any and all costs incurred as a result of any injury or damage.
By checking this box, I acknowledge that I have read and I agree to the Child & Family Center Volunteer Agreement as stated below.
I understand that I am agreeing to serve as an unpaid Volunteer (“Volunteer”) beginning on agreed upon start date at the Child & Family Center (“C&FC”). I understand and acknowledge that my time and services as a volunteer are being donated by me to C&FC, specifically the (program site) Agency location, without contemplation of compensation or future employment, and that I provide these services for charitable, or humanitarian reasons.
I understand that as a volunteer I will earn no wages or benefits in connection with the volunteer services I wish to provide, and that I will not seek any such wages or benefits. I further understand that I will not be entitled to unemployment insurance benefits upon the discontinuance of my volunteer services (regardless of whether such discontinuance is initiated by me or by C&FC), nor will I be covered under C&FC’s workers’ compensation insurance in the event I am injured while engaging in the volunteer services I will provide.
I understand that in the course of my volunteer services, I may be provided with access to, or come to be in possession of, confidential, non-public information concerning employees, volunteers, or other individuals, as well as confidential information concerning related activities.
I agree that I will honor the confidential nature of any such information, and will not disclose directly or indirectly to any person or entity outside the Agency, without express written authorization. To ensure that the needs of the volunteer position are fulfilled, the weekly requirement is hours. My scheduled hours will be determined in conjunction with the Volunteer Supervisor and the needs of the program or department I am providing volunteer services for.
The start and end dates of the volunteer service will be established between me and my C&FC supervisor. During the service period, any expense reimbursements must be approved in advance by my C&FC supervisor.
The cost of the required trainings and clearances may vary by position. The cost to complete the required volunteer clearances and trainings for the above noted volunteer position is an estimated $ , and will be covered by C&FC.
The Volunteer Position Description outlines volunteer duties and responsibilities. I understand that I may be required to attend specified training workshops and seminars and that I am required to be on time for all appointments and training responsibilities. I also understand that I am to complete required documentation on time and in accordance with C&FC policy.
If I am unable to report according to my agreed schedule due to illness or other kinds of disruptions, it is my responsibility to contact my supervisor directly at the beginning of that day. If I am unable to reach my supervisor, I will leave a message and will make contact with the supervisor as soon as they become available. It is my responsibility to call back and establish contact with my supervisor to handle any client-related concerns.
I hereby waive, release, and hold harmless from any liability or claims for damages for personal injury, including death, as well as from claims or property damage which may arise in connection with the above-named position or any associated event, the Child & Family Center, and their elected and appointed officials, agents, and employees. I hereby give permission to the Child & Family Center to use my photographs as they see fit in their advertising. I understand the photograph belongs to the previously listed organization and I will not receive payment of any kind.
I hereby agree to the Volunteer Agreement set forth on this date
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Interested in our programs, contact us now.. If you think you or someone you are taking care of has a medical or psychiatric emergency, call 911 or go to the nearest hospital. Do not delay seeking treatment or medical advice because of something you have read on this website. Our site provides health information and access to our services. It is not a substitute for professional medical advice.
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