Volunteer Application

Shared Power Volunteer Application

v02.24.23
Welcome to our volunteer application. We're excited that you've decided to volunteer with Shared Power!

*This form requests your signature in several places. You can use your mousepad to write it if on a laptop or desktop computer. For Mobile Phone use your touchscreen.

APPLICANT INFORMATION
Date*

MonthDayYear
Date
Full Name*

First NameM.I.Last Name
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
What part of Shared Power are you interested in supporting?*

Move In SupportWork Project SupportMentoring and AdvisingOther (as opportunities become available)
Are you willing to take part in a background check? (This will require your Social Security number a fee of $11.50)*

YESNO

EDUCATION/EMPLOYMENT
Student?*

YESNO
School:
Employed?*

YESNO
Employer:
Position:

EXPERIENCE & ADDITIONAL INFO
Have you Volunteered for other organizations? If so, which ones and where?*
What did you take away from that experience? *
How did you hear about Shared Power?*
Why would you like to be involved?*
List any other information or other experiences relevant to volunteering with Shared Power (i.e. special training, leadership, youth, etc.)*
Do you have any physical limitations so we can accommodate you as you support the work?*
Please list an emergency contact including name, phone number and address:*

REFERENCES

Please list two references.
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Relationship*
Company*
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Relationship*
Company*

BACKGROUND
I authorize Project I See You and/or its agents to make an independent investigation of my background, references, character, past employment, education, credit history, criminal or police records, and motor vehicle records including those maintained by both public and private organizations and all public records for the purpose of confirming the information contained on my application and/or obtaining other information which may be material to my qualifications for volunteering now and, if applicable, during the tenure of my volunteering with Project I See You. I release Project I See You and/or its agents and any person or entity, which provides information pursuant to this authorization, from any and all liabilities, claims or lawsuits in regards to the information obtained from any and all of the above referenced sources used.
Signature*

Clear
Date*

MonthDayYear
Date
Have you ever gone through any treatment for drug or alcohol abuse?
YES NO*
If yes, please explain:
Are you currently using illegal drugs? YES NO*
States lived in during the past 7 years?*

DISCLAIMER & SIGNATURE

Please sign below if you agree with the following: “If I am accepted as a volunteer, I am willing to be trained, supervised, and reviewed by a Project I See You staff member. I understand that I will be holding an important role as a volunteer, and will be expected to assume responsibilities as directed, including completion of either online or in-person training sessions when needed. I give my authorization to Project I See You or its representatives to verify the information on this form. I verify that the information on this volunteer application is true.”
Signature*

Clear
Date*

MonthDayYear
Date

Acknowledgement of Risk, Release and Waiver form
If the participant is an adult, participant agrees to the following:
- I agree to waive any and all rights and claims for damages that I, or my spouse may have against Project I See You and its agents, employees, and representatives for any and all injury, damage, or loss sustained by the participants arising directly or indirectly out of participation in this ministry.
- I further agree that, in the event that I should make any claim against Project I See You for damage, injury, or loss arising directly or indirectly out of the volunteer involvement, I will personally indemnify, defend and hold harmless the organization and its agents, employees, and representatives against any and all such injury, damage, or loss.
I affirm that I have the right to authorize and agree to the foregoing. I have read and understand this agreement and have willingly placed my signature below as evidence of my acceptance of all the conditions contained herein.
Date*

MonthDayYear
Date
Signature*

Clear
If the participant is a minor, their guardian agrees to the following:
- I agree to waive any and all rights and claims for damages that I, or my spouse may have against Project I See You and its agents, employees, and representatives for any and all injury, damage, or loss sustained by the participants arising directly or indirectly out of participation in this ministry.
- I further agree that, in the event that, my spouse, the participant, or another child in my care should make any claim against Project I See You for damage, injury, or loss arising directly or indirectly out of the volunteer involvement, I will personally indemnify, defend and hold harmless the ministry and its agents, employees and representatives against any and all such injury, damage, or loss.
- I authorize Project I See You or their representative to obtain any medical treatment for the participant that should appear necessary during the organization involvement, and I will be responsible for the payment of expenses relating to such illness or injury.
I affirm that I have the right to authorize and agree to the foregoing. I have read and understand this agreement and have willingly placed my signature below as evidence of my acceptance of all the conditions contained herein.
Date

MonthDayYear
Date
Signature

Clear
Should be Empty:

Shared Power Volunteer Application

APPLICANT INFORMATION

EDUCATION/EMPLOYMENT

EXPERIENCE & ADDITIONAL INFO

REFERENCES

BACKGROUND

Acknowledgement of Risk, Release and Waiver form