Individual Volunteer Application

1. Contact information

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Name:

 

 

 

     

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City/State/ZIP:

 

    

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If you respond and have not already registered, you will receive periodic updates and communications from Volunteers of America Mid-States.

 

 

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*3.
Question - Required - What is your preferred method of contact (check all that apply)
Please make between 1 and 4 selections from the choices below.

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*6.
Question - Required - Which areas are you interested in volunteering?
Please make between 1 and 8 selections from the choices below.

*7.
Question - Required - Confidentiality Agreement: I understand during my visit I may have access to and become acquainted with information of a confidential, proprietary, or private nature. This information is or may be applicable or related to the present or future business of Volunteers of America, its research and development, or the business of its clients. Such information includes, but is not limited to, the following: Information about clients, former clients, or persons seeking services, including names, personal information, or other program information; Financial information, vendor or donor information, contribution lists, and other information; and Marketing strategies and data, new material research, pending projects and proposals, research and development strategies, materials, products, designs, plans, ideas, and data of the organization.

*8.
Question - Required - Release of Liability: In consideration of permission granted to me to serve as a volunteer to Volunteers of America of Kentucky, Inc. or any affiliate of Volunteers of America, Inc., hereby release and discharge Volunteers of America and all of its agents, employees, officers, and directors from all claims, demands, actions, or causes of actions which I now or may ever have or which my heirs, personal representatives, or assigns may ever have against Volunteers of America, its agents, employees, officers, and directors for any personal injury or injury to real or personal property caused by or arising out of my volunteer work with Volunteers of America. I understand that under Kentucky law, I, as a volunteer of a non-profit organization who is not compensated for services, shall be immune from civil liability for acts of omission on connection with my services as a volunteer, which result in damage or injury, subject to certain restrictions.

*9.
Question - Required - Background check

   Please leave this field empty

     

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