Volunteer Application

Volunteer Application

Thank you so much for your interest in volunteering with Pivot! We are excited to have you! Let me start off by explaining the process. Any interested volunteer will fill out the attached application. You have the option of filling it out and then emailing it back to me or bringing it with you on your scheduled volunteer day. For our first-time volunteers, and anyone volunteering less than 20 hours, the volunteer positions are mostly organizational and staff support. So, our clothing, shoes, household, and Tiny Home décor closets, our food pantries, and sorting room are always in need of volunteers to help organize those. Sometimes staff have special projects or need an extra hand when it comes to a task and volunteers can help with that as well! Volunteering schedules and shifts are decided by the volunteer! You can come and go to fit the needs of your schedule! Please note that we will not be able to schedule volunteer shifts after 5pm Monday-Friday or during the weekend unless it is for a group larger than 5. For our volunteers that have shown a commitment of 20 documented volunteer hours or more, a background check can be done to make sure that they are eligible to work with youth. For the safety of our youth, no one can volunteer with them unless a background check has returned clean.
Volunteer Information and Release
How do we address you?*

Mr.Ms.other
Name*
Address*

Home Address

Street Address Line 2

City, State, ZipState / Province

Postal / Zip Code
Email*
example@example.com
Birth Date*

MonthDayYear
Date
Primary Phone*
Secondary Phone*
Employer/Occupation*
Emergency Contact*
Emergency Contact Relationship*
Emergency Contact Phone*
Area(s) of Interest*
Are you 18 years of age or older? May we use your name/image in promotional releases, social media and newsletters? Please email me Pivot's newsletter and updates on activities.YesNo*

YesNo
May we use your name/image in promotional releases, social media and newsletters?*

YesNo
Please email me Pivot's newsletter and updates on activities.*

YesNo
The best time for me to volunteer Monday through Friday is*

9:00 am to 11:00 am2:00 pm to 4:00 pmPlease contact me about a time
The following day(s) are best for me to volunteer.*

MondayTuesdayWednesdayThursdayFriday
Volunteer Agreement and Liability Release Form

In consideration of my desire to serve as a volunteer for Pivot, Inc. I hereby assume all responsibility for any and all risk of property damage or bodily injury that I may sustain while participating in any client management, building maintenance or other activity related to my service at Pivot.

I understand that some volunteer positions will require the completion of a criminal background check and/or drug screening. I understand that I am not to take photos of clients and that the safety, well-being and confidentiality of the youth served are a priority to Pivot.

I understand that some volunteer activities are physically demanding. If I am physically limited, Pivot will attempt to find an activity that allows me to participate as intended or expected of me.

I understand that Pivot is under 24-hour surveillance and that possession and use of alcohol, tobacco, illegal substances, firearms and weapons are prohibited on Pivot's campus and at any events. find If I myself in an unsupervised situation with a minor, I will ask the minor where their youth advocate is, and/or direct them to the receptionist. Unless noted above, I also give consent to have my photo taken, be interviewed and/or filmed for marketing purposes to promote the mission of Pivot. I further permission grant to Pivot to use, without compensation or approval any photographs, videos or audio recordings taken of me while volunteering or participating in Pivot activities. By my signature below, I do release and indemnify, and hold harmless Pivot from and against any and all claims, actions, suits or proceeding of any kind or nature arising as a result of the actions of my child. I also release the officers, staff and Board of Trustees of Pivot, without limitation, for damages, liabilities, penalties, costs, expenses, legal fees and claims.

I acknowledge that I have carefully read and understood this release and am voluntarily executing this release.
Print Full Name*
Date*

MonthDayYear
Date
Signature*

Clear
If minor, Parent/Guardian Signature

Clear
This agreement is valid for one year, beginning on the above date.
CONFIDENTIALITY/PRIVACY AGREEMENT
Every effort needs to be made to protect all client privacy.

The following guidelines are to be observed in an effort to protect the confidentiality/privacy of all people either applying for or receiving services from Pivot, Inc.: 1. Communications regarding clients or client activities are not permitted outside Pivot. Individual clients are never to be discussed by name outside Pivot. 2. Clients and/or client-related issues are not to be discussed in reception areas or where others are present to overhear the

3. No photos, videos or any recording of clients are allowed unless a signed release is on file for that client and you receive express permission from your supervisor, the Chief Executive Officer or the Pivot staff member you are visiting. 4. Do not leave anything (letters, notes, files, etc which contains client names or information where it could be read by anyone. At the end of a working/volunteer day, all information containing a client name should be locked up. 5. If you see/meet a client away from Pivot, Inc., wait for the client to initiate contact/speak first. This method of protecting the client's privacy is to be explained to clients at the time of intake (initial session

All guidelines regarding release of information from the client record are discussed in Pivot's Policies and Procedures Manual. In addition, the Policies and Procedures Manual discusses confidentiality/privacy and the necessity of refraining from having social interactions with clients and

Any additional questions about confidentiality or privacy are to be referred to your supervisor, the Chief Executive Officer or to the Pivot, Inc. staff member you are visiting.

A breach of confidentiality is grounds for dismissal from employment or volunteer status at Pivot, Inc. If a breach of confidentiality occurs by a non-staff member which results in legal action against him/herself, he/she will indemnify and hold harmless Pivot, Inc. Iagree to abide by Pivot, Inc.'s confidentiality/privacy policies and to protect, at all times, a client's right to privacy.
Name*
Signature*

Clear
Date*

MonthDayYear
Date
Position/Title*
Should be Empty:

Volunteer Application

CONFIDENTIALITY/PRIVACY AGREEMENT