Volunteer Interest Registration

VOLUNTEER REGISTRATION FORM

Welcome and thank you for your interest in volunteering with the Adopt A Single Mom (AASM) Project and serving the working single mom community.

If you have a heart to serve and a passion for empowering and uplifting women then please complete our application.

Our mission is to create a movement providing direct support to empower working single moms of NEPA and beyond filling the gaps with a network of sustainable resources and support to enhance their quality of life so they can be the best version of themselves to thrive as moms and women of our community.

There are many ways to support this inititative and we are seeking a variety or skills, interests and abilities to join us throughout the year on our various projects, and to further our vision.

FIRST STEP HERE

BEFORE PROCEEDING WITH FILLING OUT THIS FORM WE'LL NEED YOUR VOLUNTEER BACKGROUND CHECK COMPLETE. IT'S FREE AND TAKES ONLY A COUPLE MINUTES TO SUBMIT AND GET A RESPONSE. ONCE COMPLETE YOU WILL HAVE A CONTROL NUMBER WHICH IS USUALLY A COMBO OF LETTERS AND NUMBERS.

WE NEED YOU TO PROVIDE THE CONTROL NUMBER IN A SECTION BELOW. THIS WILL BE VALID WITH US FOR ONE YEAR.

Even if you have one from work or previous volunteer work - you must still follow our procedure. Submitting anything other than a background check dated more than 10 days from your volunteer application will not be accepted.

TAP HERE TO GO TO THE PSP PA VOLUNTEER BACKGROUND CHECK FORM.

What's inspiring you to want to volunteer with us? (10 word minimum) *

0/0

Name*

First NameLast Name

If you are volunteering on behalf of your work/business - type business name below

Email*

example@example.com

Mobile Telephone*

Please enter a valid phone number.Format: (000) 000-0000.

Alternate Telephone

Please enter a valid phone number.Format: (000) 000-0000.

Personal (not work/business) Address*

Street Address

Street Address Line 2

CityState

Zip Code

Recent headshot/Profile Picture of ONLY YOU WITHOUT FILTERS. Please do not provide a picture that includes other people. We use your picture to be able to identify you and share it with other team members for group initiatives. Providing your picture gives us permission to share publicly as part of our volunteer team which could include flyers, website, social media, and to our email subscribers, partners and affiliates. *

Provide your first name, last name and date of birth exactly as you submitted on your PA State Police Criminal Background Check *

Provide the CONTROL NUMBER from your PA State Police Criminal Background Check OR upload a copy of the certificate dated today below. *

Control number begin with the letter R

Which social media platforms do you use?*

FacebookInstagramLinkedinNone

CHOOSE ALL THE VOLUNTEER AREAS OF INTEREST

Help with Programming

Annual Christmas Gift Drive (starts October)Regional Community Resource Event (Winter/Early Spring)Training/Subject Matter Expert PresenterPeer to Peer MentorshipProgram and Curriculum DevelopmentTherapist/Counselor to Support our Mental Well-Being Support via Text and Virtual Workshops

Community Resource Vendor and Dinner Event March 10, 2022

Errands for Supplies/DonationsGreeter for Registration TableKids Room Monitor and ActivitiesAASM Project Information TableAssist with Coordination of Guests and Activities day of eventErrands/Outreach to community businesses for donations for raffle baskets

Outreach

Behind the Scenes

Program developmentResearch/Technical/Data junkieTechnical: website development, spreadsheet managementSocial Media ManagementContact/Database management, Phone Calls, data entryResearch, technical writing, grant writingCreative and persuasive writing, proofreading

Social and Emotional Support

Program Support OfferingsOther

What are your 'other' ideas - if you checked Other

Board of Directors and Professional Support

Board of DirectorsNon-Voting Board Impact Committee (Finance/Fundraising; Outreach/Community Engagement: Membership for single moms)Offer pro bono professional services/skills

In the section below please share any additional specific ways of what and how you can support our organization, and anything else you would like to share. (Optional)

In an effort to streamline and quickly get interested volunteers started and to do our best to ensure a great fit we have established a 2-step process to get started. As a volunteer with the Adopt A Single Mom Project you will be required to attend and complete our virtual orientation, and participate in communication updates via the digital platform SLACK which means you will need to download the app to your phone/desktop. All support for setup, etc. will be available for you. The next step in the process will be to watch the orientation overview video (in lieu of a in-person group) answer questions about the AASM Project and volunteering, along with a very brief written summary of your interest serving your time with our initiative. Will you agree to complete these two requirements?*

YesNo

All volunteers will receive our text service for communication. By checking this box you agree to receive text messages from AASMP in relation to volunteer activities. Message frequency may vary. Message and data rates may apply depending on your carrier agreement. You'll be able to respond HELP for help or STOP to cancel receiving messages at any time. Your phone number will not be shared or sold to any third parties. You must be willing to join the text communication, as that is how we push out reminders and any last-minute changes to ensure you receive them as soon as possible. Also, in an effort to streamline and quickly get interested volunteers started and to do our best to ensure a great fit, you may be required to attend and complete our virtual orientation for the role you sign up for. Will you agree to complete these two steps?*

YesNo

You agree to take the necessary actions to take responsibility for my own personal health and safety. You will not participate in any in-person event if you have experienced symptoms that of fever, fatigue, difficulty in breathing, or dry cough or exhibiting any other symptoms relating to COVID-19 or any communicable disease within the last 10 days prior. You agree that this extends up to the date and time you may be volunteering with the AASM Project at any future date, and agree to communicate any change with the organization including if necessary declining your volunteer role due to exposure and symptoms. You understand you are fully and personally responsible for your own safety and actions while and during your participation and you recognize that you and your chil(dren) may be at risk of contracting COVID-19 and/or any variants. You agree to indemnify, defend, and hold harmless the Organization (AASM Project) from and against any and all costs, expenses, damages, lawsuits, and/or liabilities or claims arising whether directly or indirectly from or related to any and all claims made by or against any of the released party due to injury, loss, or death from or related to COVID-19.

I understand and agree

As an all-volunteer organization, we rely on you to achieve our mission. To maintain the integrity of our brand and programs, you promise to follow the criteria and guidelines provided to you to ensure consistency in delivery and outcomes. This simply means you will do things the way we have designed and requested. If you like finding shortcuts or doing things your own way, we are not the organization for your volunteer time.*

I understand and agree

At times, you may have access to personally identifiable and vulnerable information that has been shared with us by those we serve. You promise to protect this information and will not share it verbally, written, photograph, or any other media with anyone outside the organization. You promise to not maintain copies of any identifiable and vulnerable information in your possession beyond the extent of project you are volunteering.*

I understand and agree

You promise to not retain any contact information of our volunteers and participants we serve to contact for other personal reasons.*

I understand and agree

You promise to not co-mingle your personal affairs with our organization. For example, you may not try to offer your own product/service or solicit in any way to those we serve while you are volunteering with our organization. We want to be sure there is clear communication in what our program/service provides.*

I understand and agree

Are you at least 18 years old?*

YesNo

You may at some point be using your transportation for a volunteer activity. Do you certify that your vehicle or any vehicle you may be driving during your volunteer activities has liability insurance coverage?*

YesNo

Thank you for your interest in supporting and volunteering with our wonderful organization. After your application is reviewed, additional information will be sent to you via email with next steps and or additional requests for information. In the meantime if you want to reach out to us you can email: adoptasinglemomnepa@gmail.com. Call 570-762-9913.

*** Incomplete and inaccurately submitted applications get deleted. An email notification will be sent to you letting you know the deficiency and offering you to resubmit. If you have questions or concerns, please email us to address them prior to submitting your application.

www.adoptasinglemom.org

PRIVACY POLICY | TERMS OF SERVICE