Kim4Kids Volunteer Registration Form
Thank you for your interest in volunteering with ๐๐ข๐ฆ4๐๐ข๐๐ฌ. This form helps us connect dedicated volunteers to opportunities that advance our mission and vision of creating meaningful support, access, and positive outcomes for the children and families we serve.
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Respondent Information
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Education and Work History
High School Attended
*
College and Major
*
Current Employer
*
Emergency Contact Information
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Relationship
*
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๐๐ฅ๐๐๐ฌ๐ ๐ข๐ง๐๐ข๐๐๐ญ๐ ๐ญ๐ก๐ ๐ฉ๐ซ๐ข๐ฆ๐๐ซ๐ฒ ๐ซ๐๐๐ฌ๐จ๐ง ๐๐จ๐ซ ๐ฒ๐จ๐ฎ๐ซ ๐ข๐ง๐ญ๐๐ซ๐๐ฌ๐ญ ๐ข๐ง ๐ฏ๐จ๐ฅ๐ฎ๐ง๐ญ๐๐๐ซ๐ข๐ง๐ ๐๐ญ ๐๐ข๐ฆ4๐๐ข๐๐ฌ. Note: Expectations and responsibilities may vary based on your selection. If you're observing for school requirements you may be required to submit documentation or evaluation forms.
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General Volunteer Support (helping with daily tasks, programs, and events)
Observation/Shadowing Hours (to fulfill academic or certification requirements)
Specific Reason for Volunteering
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How did you hear about Kim4Kids?
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How many hours are needed?
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Times and Days Available
*
Monday
Tuesday
Wednesday
Thursday
Friday
Available Start Date
*
ย -
Month
ย -
Day
Year
Date
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Announcement: Social Media Volunteer Opportunity
Weโre excited to share that volunteers can now sign up for a Social Media Volunteer role while still earning OT/PT observation hours. In this role, youโll help capture content and support our online presence during events, while engaging with and observing participant interactions.This experience can be credited toward your observation hours.
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Skills
Please rate how a supervisor or teacher would rate you on the listed skills using the linear scale below.
Punctuality
*
Very Poor
1
2
3
4
Very Good
5
1 is Very Poor, 5 is Very Good
Communication
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Very Poor
1
2
3
4
Very Good
5
1 is Very Poor, 5 is Very Good
Organization
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Very Poor
1
2
3
4
Very Good
5
1 is Very Poor, 5 is Very Good
Teamwork
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Very Poor
1
2
3
4
Very Good
5
1 is Very Poor, 5 is Very Good
Customer Service
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Very Poor
1
2
3
4
Very Good
5
1 is Very Poor, 5 is Very Good
Problem Solving
*
Very Poor
1
2
3
4
Very Good
5
1 is Very Poor, 5 is Very Good
Do you have any certifications such as First Aid, Basic Life Support, and CPR?
*
Yes
No
List certifications and dates obtained
List other volunteer experience with organizations
Any accommodations needed
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Background Check
All Kim4Kids volunteers are subject to a criminal background check. If you have a background check already, please attach it below. If you do not have a background check, please obtain a background check from one of the two locations: JP- 1233 Westbank Expressway Harvey, LA (brown building) Open M-F (8am-4pm)OP- 715 South Broad St. 1st floor New Orleans, LA 70119 Open M-F (9am-3pm) *You will need to have your ID with you*Once completed, please email copy of background check to curt@kim4kidsnola.com. After your background check is reviewed and you are approved, Curt contact you via email to schedule a 30 min virtual onboarding meeting.
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Volunteer Agreementย
At Kim4Kids, we are committed to creating a safe, respectful, and supportive environment for every child, family, staff member, and volunteer. Ourย Code of Conduct Agreementย outlines the expectations that help maintain this positive space. It is essential that all volunteers understand and follow these guidelines to ensure the safety, privacy, and well-being of our children and community.
Volunteer Duties
As a volunteer, you will be required to assist therapists by preparing therapy rooms, setting up activities, ensuring safety for patients and therapists, and picking up items at the end of sessions. Other duties include but are not limited to creating labels, unpacking delivery orders, re-boxing games, laminating game cards, organizing supplies, cleaning the office, taking out the trash, washing dishes, watering the plants, etc. Your scheduled volunteer days and hours will be determined with pre approval from Kim4Kids.ย
Final Agreement
This agreement applies to the volunteer applying for Kim4Kids. All data, materials, knowledge, and information generated through, originating from, or having to do with Kim4Kids or persons associated within it, is to be considered privileged and confidential and is not to be disclosed to any third party. This includes, but is not limited to pages, forms, information, designs, documents, printed matter, policies and procedures, conversations, messages (received or transmitted), resources, contacts, e-mail lists, e-mail messages, client, staff, or public information is confidential and the sole property of Kim4Kids. Any disclosure, misuse, copying or transmitting of any material, date, or information, whether intention or unintentional, will subject volunteer to disciplinary action, prosecution, and/or monetary damages according to the procedures set by Kim4Kids and any applicable law. The agreement below acknowledges his/her agreement to the aforementioned terms.
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Please review your information and submit your application.
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