WE CARE, INC.
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Volunteer Application


WE CARE, INC.  Volunteer Application

I.  CONTACT INFORMATION:

Name (Last, First, Middle):

___________________________________________________________________________

Home Address (City, State, Zip):

___________________________________________________________________________

Home Phone: (______)____________________  Cellular:(______)_____________________

E-mail: ____________________________________________________________________

Work Phone:(____)__________ Fax: (____)___________ Date of Birth: ________________

II. BUSINESS INFORMATION:

Does your company offer a matching gift fund or company contribution for your volunteer

services?      ____Yes      ____No

Employer: ________________________________________________________________

Current Occupation: __________________________________________________________

Work Address (City, State, Zip): ________________________________________________

___________________________________________________________________________

How did you hear about us?

___________________________________________________________________________

Can you communicate in any languages other than English?   If yes, please list the languages.

Language:________________ Speak: __Yes  __No   Read: __Yes   __No   Write:  __Yes   ___No

Language:________________ Speak: __Yes  __No   Read: __Yes   __No   Write:  __Yes   ___No

III. EMERGENCY CONTACT:

Name: _________________________________________________________________________

Relationship: ___________________________________________________________________

Home Phone: (____)__________ Work Phone:(____)_________ Cellular:(____)_____________

IV. Educational Background:

School: _________________________________________________________________________

Area of Study: ______________________________________  Graduation Date: _____________ 

V. PLEASE MARK ALL AREAS OF INTEREST:

____Clerical Aide - Data entry, and help prepare packets

____ Direct Services - (early childhood experience or CPR/FA instructor certification useful) - Help facilitate training childcare providers, parents and healthcare professionals

____ Food Pantry Processor - Process food baskets from inventory. 

____ Fundraising - Assist with the development and implementation of special events

____ Marketing/Communication - Assist with upkeep o website, work on newsletters, research news groups and agencies, write press releases, assist with special events

____ Outreach - Distribute information at community events and health fairs, talk to                 groups about our services, assist in the creation of new materials.

____ Translation - Translate materials into another language - Spanish, Vietnamese,Chinese.

VI. GENERAL QUESTIONS:

____Monday    ____Tuesday    ____Wednesday    ____Thursday   ____Friday    ____Saturday

Would you be available occasionally to help on special projects or special events outside of
your normal volunteer schedule?   ____Yes      ____No

What are your areas of interest? ________________________________________________

___________________________________________________________________________

Do you need special accommodations to volunteer? ____Yes      ____No  (If yes, please describe)

___________________________________________________________________________

Do you have reliable transportation and a valid Texas driver’s license?     ____Yes      ____No

Are you at least 18 years of age?     ____Yes      ____No

Can you perform all the essential elements of the volunteer position with or without accommodations?     ____Yes      ____No

Have you previously served as a volunteer for We Care, Inc?     ____Yes      ____No

(if yes, when?)___________________________________________________________________

What would you like to gain from participating as a volunteer with We Care, Inc?

___________________________________________________________________________

___________________________________________________________________________

What strengths do you possess that are relevant to our programs?

____________________________________________________________________________

VII. BACKGROUND CHECK INFORMATION:

Have you ever been convicted of a criminal charge, plead guilty or no contest in order to

quality for deferred adjudication? You may exclude traffic violations.     ____Yes      ____No
If yes, please explain.  Conviction will not necessarily exclude you from volunteering.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

I, on behalf of myself, my personal representatives, assigns, heirs, and next of kin, do hereby agree to indemnify and hold harmless We Care, Inc., its employees, volunteers or agents (the "Released Parties") from any and all claims or causes of action that may arise out of the performance of my assigned duties as consideration of my participation as a volunteer for We Care, Inc.

IT IS MY EXPRESS INTENTION AND THE EXPRESS INTENTION OF THE RELEASED PARTIES THAT THE RELEASE PROVIDED FOR IN THIS AGREEMENT RELEASE THE RELEASED PARTIES FROM THE CONSEQUENCES OF THE ACTS OR OMISSIONS OF THE RELEASED PARTIES, INCLUDING ACTS OF NEGLIGENCE OR ALLEGED NEGLIGENCE, AND INCLUDING HERE SAME ARE THE CONTRIBUTING CAUSE OF THE CLAIM.

I acknowledge that this waiver and release is being signed by me voluntarily, without coercion, duress, or undue influence and with full knowledge of its terms and effects.  I have read, completed and understand all of the above and release of liability and understand the contents.

The facts set forth above in my application for a volunteer assignment are true and
complete. I understand that if I become a volunteer for We Care, Inc., false statements on this application shall be considered sufficient reason for dismissal.

_____________________________________________________        ______________________ Signature                                                                                                                 Date

Please submit the following documents: 

1.  Completed and signed Volunteer Application

2. Completed and signed Consent for Criminal Background History Check if you will be volunteering in the CACFP or off-site educational volunteer. 

3. Your resume, optional

4.  See HOME Page Contact us for submission address.