Volunteer Application Form

 

 

Date of Application___________

 

 

Name:

 Social security #:

 

Address:

 

 

 

Telephone Number (Home):

           

(Work):

Date of Birth:

 

Sex:

Emergency Contact Person:

 

Phone:

Which county do you reside in?

How long have you lived there?

 

 

Educational Background

1.    High School: How many years did you attended?: _______________________

2.    High School Attended: _____________________________________________

3.    College Degree:

4.    Degree(s):                                                                                                       

5.    Major(s):________________________________________________________           

6.    College Attended:_________________________________________________

 

Employment

Present Employer: ____________________________  Phone #:_______________

Type of Employment: _________________________________________________

Work Schedule: ______________________________________________________

 

Volunteer Experience

Have you ever done volunteer work before? ____Yes  ____ No

If yes please fill in below:

Organization Name:____________________________ Phone #:_______________

What type of volunteering did you do? ____________________________________

___________________________________________________________________

______________________________________________________________________________________________________________________________________

Are you currently volunteering? ____ Yes ____ No

 

 

If no, why did this volunteer experience end? ______________________________

_________________________________________________________________________________________________________________________________________________________________________________________________________

Please list any previous experience with children and teenage youth and in what capacity: ___________________________________________________________

______________________________________________________________________________________________________________________________________

Reason for volunteering: _______________________________________________

______________________________________________________________________________________________________________________________________

 

Availability

Area you would like to volunteer: ________________________________________

What days would you like to volunteer? ___________________________________

Hours: _____________________________________________________________

List three references other than relatives that have knowledge of your qualifications, morals and/or character. Please include full name, address and phone number.

1) _________________________________________________________________

2) _________________________________________________________________

3) _________________________________________________________________

 

 

Boys & Girls Clubs of Middle Tennessee

Authorization for Police Check

 

A police check regarding your criminal record is required in able to volunteer. By signing and dating this application you are allowing Boys & Girls Clubs to request a police check on application named below.

 

Signature: _____________________________________  Date: _______________

 

Any false statement or misrepresentation made as part of this application may be cause for termination or disqualification of application.

 

Additional comments: _________________________________________________

______________________________________________________________________________________________________________________________________

 

Mail completed application to:        Boys & Girls Clubs of Franklin/Williamson County

                                                Attention: Denise Carothers

                                                P.O. Box 1084

                                                Franklin, TN  37065

 

FOR OFFICE USE ONLY:

App rec’d/background requested ________________

Background completed/returned ________________

Volunteer notified ___________________________

Other _____________________________________


 

Volunteer Code of Ethics

 

1.    Volunteers will never leave a child unsupervised.

2.    A volunteer is not to be alone with one child except in an emergency or in otherwise unavoidable circumstances.

3.    Volunteers will not abuse children including:
  • Physical Abuse - strike, spank, shake, slap
  • Verbal Abuse - humiliate, degrade, threaten
  • Sexual Abuse - including inappropriate touching

4.      Using, possessing or being under the influence of alcohol or illegal drugs during the hours of operation is not allowed.

5.      Smoking or use of tobacco products in the presence of children or parents during Club hours is prohibited.

6.      Volunteers must appear clean, neat and appropriately attired.

7.      Volunteers will treat children of all races, religions and cultures with respect and consideration.

8.      Volunteers will use positive techniques of guidance, including redirection, anticipation of and elimination of potential problems, positive reinforcement and encouragement rather than competition, comparison or criticism.

9.      Volunteers will abstain from humiliating or frightening discipline techniques.

10.     Volunteers will not use profanity in the presence of children or parents.

11.     Volunteers will refrain from intimate displays of affections toward others in the presence of children, parents and staff.

12.     Monetary and expensive gifts to staff are prohibited, as are volunteer gifts to youth except for high school graduation.

13.     While Boys & Girls Clubs of Middle Tennessee does not discriminate against an individual's lifestyle, we will require that in the performance of their duties, volunteers will abide by the standards of conduct set forth by Boys & Girls Club.

14.     Volunteers must be free of physical and psychological conditions that may adversely affect children's health including significant fever or contagious conditions.

15.     Volunteers will portray a positive role model for youth, including but not limited to, maintaining an attitude to respect, loyalty, patience courtesy, tact and maturity.

 

I understand that any violation of the Code of Ethics may result in termination of my volunteer activities.

 

Signed__________________________________

 

Date_______________________