Stanford Home for Children Volunteer Application

 

Date:
Last Name: First Name: MI:
Address: City: State: Zip:
Phone Numbers
Home: Work: Mobile:
Email: How did you hear about Stanford Home?
Referred by: Nature of Aquaintance:
Do you possess a valid California Driver's License? Yes No
Are you over 18 years of age? Yes No
Specific area of interest (for example board/committee member, special events, technical support, etc.):
Are you able to perform the essential functions of volunteer positions, either with or without reasonable accommodation? Yes No
If no, describe the functions that cannot be performed:

(Note: We comply with the ADA and consider reasonable accommodation measures that may be necessary for eligible applicants to perform essential functions. Acceptance for volunteering may be subject to passing a medical examination, and skill and agility tests. )

Availability: Please list specific days, times, and/or events that you are available to volunteer for:
Days of the week:
Hours:
Special Events:
Previous volunteer experience:
Have you ever been convicted of a crime? Yes No
(Conviction does not necessarily disqualify applicant from volunteering.)
If yes, please explain:
List skills or talents, which you posses that may be useful in volunteering with Stanford Home. Please include any resources that you have access to that may be of benefit:
List names and address or phone numbers of three references other than relatives who can give information about your background, character and abilities:
Name
Address/Phone
Nature of Acquaintance
(Supervisor, Teacher, etc.)

It is our policy to comply with applicable state and federal laws prohibiting discrimination in volunteering based on Age (40 and over), Ancestry, Color, Religious Creed, Denial of Family and Medical Care Leave, Disability (mental and physical) including HIV and AIDS, Marital Status, Medical Condition (cancer and genetic characteristics), National Origin, Race, Religion, Sex, Sexual Orientation, or any other protected classification.

PLEASE READ CAREFULLY and certify below.

I certify that the information I have included in the Volunteer Application is true and complete to the best of my knowledge.

I understand that omitting or misrepresenting any information in or required for this application will result in Stanford Home for Children's rejection of my application, or termination of my volunteerism.

I authorize Stanford Home for Children to investigate my references, background, or any other matters relating to my suitability for volunteering. I also authorize my provided references to share information with Stanford Home for Children.

I understand that I am not considered an employee of Stanford Home while performing volunteer work for the organization.

I further understand that as a volunteer, I am not covered by Workers' Compensation insurance (medical coverage or loss of wages) for injury that may occur while I am acting as a volunteer.

In connection with my voluntary involvement in activities undertaken for, and with the participation and support of Stanford Home, a nonprofit organization, I hereby agree, for myself, my heirs, assigns, executors, and administrators to release and discharge Stanford Home, its officers and directors, employees, agents and volunteers from all claims, demands, and actions for injuries sustained to my person and/or property as a result of my involvement in such activities, whether or not resulting from negligence and I agree to release and hold Stanford Home, its officers and directors, employees, agents, and volunteers harmless from any cause of action, claim, or, suit arising wherefrom.

I hereby attest that my attendance and involvement in such activities is voluntary, that I am participating at my own risk, and that I have read the foregoing terms and conditions of this release.

I hereby confirm, represent, and warrant that I have never been convicted of or charges with a violent crime, child abuse or neglect, child pornography, child abduction, kidnapping, rape or other sexual offense, nor have I ever been ordered by a court to receive psychiatric or psychological treatment in connection therewith. A Department of Justice background check may be required for my affiliation with Stanford Home and I agree to submit to this check.
Checking this box functions as my signature and certifies that I have read and agree to the above terms of this volunteer application.
Volunteer Applicant's Name: Date:
Checking this box functions as my signature and certifies that I further grant to Stanford Home, its assigns and successors, my consent and full right to use my name, photograph, likeness, image, voice, and biography in any and all media, publications, advertising, and publicity in connection with my participation hereunder.
Volunteer Applicant's Name: Date:
 
If you have any questions or need assistance with this application  please contact Development - or send email to info@stanfordhome.org