VMA Volunteer Form

Volunteer Application
Name*

First NameLast NameSuffix
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Preferred Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Preferred Email*
example@example.com
Date of Birth*

MonthDayYear
Employed?*
Employer
Job Title
Description of job duties
Are you a member of an organization or group of volunteers?*
Please specify the name of the organization or group
Educational AssistanceSpecial EventsProjectsAfter School Assistance
Describe any experience working with young people*

References
Relationship to volunteer*
The relationship between child and volunteer demands a high level of confidentiality. Volunteers become aware of the problems and confidences of students, their parents and the school staff. These should never be discussed with anyone who does not have a professional right or need to know. If a volunteer suspects neglect, abuse, unlawful acts, or believes a student’s well-being is threatened, it becomes the duty of the volunteer to report the matter. It will not be considered a breach of confidentiality to discuss such incidents with the classroom teacher, school family and student resource liaison, Dean of Students or Principal.

I have read the above statement and will respect the confidentiality of the students and staff with whom I will be working.
Signature*

Clear
Today's Date*

MonthDayYear
Please verify that you are human*
Should be Empty:

Volunteer Application