Volunteer Application – Neighborhood House

Contact Info

Name *

Date *

Address *

City *

State *

Zip *

Phone *

Email *

Employer or Group Association

Areas of Interest and Skills

I am interested in the following recurrent activities:

Meals-on-Wheels: package bread & fruit

Pet Food: package food/deliver to clients

Food Pantry: stock shelves/client pick-up

Maintenance: grounds keeping/painting/projects

Administrative: typing/filing/mailings

I am interested in the following seasonal activities:

After-School Meal Program: monitor kids' activities

Summer Lunch Program: monitor kids' activities

Coat Giveaway: set up/help shoppers

Santa-for-Seniors: wrap gifts/deliver gifts

Fundraisers: Food Fight/RAGBRAI/Saddle Up

Christmas Angel Tree

If you selected Art, Crafting, Coaching or Tutoring, please specify:

Art Medium(s)

Crafting Type(s)

Coaching Sport(s)

Tutoring Subject(s)

Availability

Note: Weekend and Evening events are very limited

I am available:

Regular basis

One-time project/event

Flexible

Days of the Week/Hours Available

Additional Info

How did you hear about Neighborhood House Association, and why are you interested in volunteering with us?

Do you speak any languages besides English? If so, please list:

Do you have a current driver's license? *

Yes

Do you have proof of current automobile insurance? *

Yes

Have you ever been arrested? *

Yes

Convicted of having committed any crime? *

Yes

If yes to either, please describe in full:

Photo/Video Release

Thank you for choosing to make a difference in the lives of those we serve by volunteering at Neighborhood House. We believe in creating and capturing memories that last a lifetime. From time to time, we may take a photo or video of you interacting with our program participants and employees. By signing below, you are stating that you understand your image may be edited, copied, exhibited, published or distributed in print and may be used on the www.nhpeoria.org website, and that you waive the right to inspect or approve the finished product wherein any likeness appears. Additionally, you waive any right to royalties or other compensation arising or related to the use of your image or recording with the understanding that this material may be used in diverse educational or promotional settings within an unrestricted geographic area deemed appropriate by Neighborhood House Association.

Photo/Video Release Virtual Signature *

Date *

Emergency Contact

Name *

Phone *

Volunteer Code of Conduct

Our children, youth, and elderly are the most valuable gifts entrusted to Neighborhood House Association. It is our obligation to give and set a good example of charity, kindness, and integrity to those we serve. As a volunteer at Neighborhood House Association, you must uphold the following:

Assignments

Be dependable, recognizing the commitment and responsibility to all volunteer assignments
Accept volunteer assignments that are consistent with your interests, abilities, and available time
Accept volunteer assignments with an open mind and a willingness to learn
Accept feedback from Neighborhood House Association personnel in order to do the best job possible

Respect

Treat everyone in whom you encounter with a sense of dignity, respect, and worth
Be nonjudgmental about cultural differences, living conditions, and the life-style of all program participants
Avoid profane and abusive language and disruptive behavior that is dangerous to self and others
Respect all confidential information regarding Neighborhood House Association and those we serve
Do not pressure anyone to accept any political, cultural, or religious beliefs

Safety

Adhere to all Neighborhood House Association rules and procedures
Work environments should not contain offensive or objectionable material (slogans or graphics)
Follow safe workplace practices and report any accident, injury, or unsafe situation to any agency Director
Report suspected abuse of any child or vulnerable adult to any Agency Director
Report suspicious activities to any agency Director
Failure to do the above or to satisfactorily perform volunteer assignments is cause for dismissal

Behaviors that must never occur:

Performing any illegal activity on campus or during any off-site Neighborhood House Association event
Touching anyone in an inappropriate manner or any type of verbal or physical harassment
Speaking in a manner that humiliates or degrades program participants and others we serve
Possessing, using, or being under the influence of alcohol, illegal, or drugs at any time
Developing inappropriate personal relationships with program participants and others we serve
Using photo, audio or video recordings without authorization by Neighborhood House Association’s CEO in any capacity including Social Media (e.g. Facebook, Linked-In, Twitter, blogging, etc.)
Using Neighborhood House Association equipment and resources for personal use
Accepting money from program participants for personal use

My signature confirms that I have read and understand this Code of Conduct. I agree to uphold and follow these standards. I understand that any behavior that is inconsistent with these standards may result in my dismissal as a Volunteer with Neighborhood House Association.

Volunteer Code of Conduct Virtual Signature *

Date *

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