FORESIGHT ADVENTURE GUIDES FOR THE BLIND
NEW VOLUNTEER APPLICATION
We appreciate your interest in our organization. Applications are received and volunteers are accepted without regard to race, creed, color, sex, religion, age, national origin or physical or mental disability. The receipt of this application does not mean that openings exist, nor does it obligate Foresight Ski Guides in any way.
Personal Information:
Full Name:
First Name
Last Name
Date of Birth:
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Current Mailing Address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Telephone:
Format: (000) 000-0000.
Email:
example@example.com
Previous Address: (If less than 5 years at current address)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Occupation
Present Employer:
Employer's Address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
No. of Years Employed:
Employer's Tel. #:
Format: (000) 000-0000.
Person to be notified in case of emergency:
Name:
First Name
Last Name
Relationship
Address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Tel #
Format: (000) 000-0000.
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Do you have personal health insurance?
Yes
No
A copy of your health insurance card is required.
Have you applied to Foresight Ski Guides before?
Yes
No
If yes, when?
Are you a veteran of the US military?
Yes
No
Branch of Service
May we put your name, email address and phone number on a list available to all Foresight volunteers?
Yes
No
Are you 18 years of age or older?
Yes
No
Have you been convicted of a felony (excluding any record or conviction that has been judicially sealed, expunged, eradicated or dismissed)?
Yes
No
If yes, please explain (a conviction will not necessarily disqualify your application):
Have you ever been charged with child neglect or abuse?
Yes
No
If yes, please explain:
Has your drivers' license ever been suspended or revoked?
Yes
No
If yes, please explain:
Are there any facts or circumstances involving you or your background that would call into question your being entrusted with the supervision, guidance or care of youth or disabled individuals?
Yes
No
If yes, please explain:
Do you hold any specialized training or experience in working with people with visual or physical disabilities?
Yes
No
If yes, please describe:
Do you have experience with American Sign Language?
Yes
No
If yes, please give details:
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Do you have any current medical certifications:
CPR
Basic First Aid
Other
If you are PSIA/AASI, ACA, or certified by any other officially recognized body, please list type & level of certification:
Ski Season Only: Will you have a season's pass for the upcoming ski season?
Yes
No
If yes, which type?
Summer Only: Do you have experience teaching/instructing any of the following activities? (check all that apply)
Stand Up Paddle Boarding/Kayaking/Canoeing
Rock Climbing
Hiking
Archery
Fly Fishing
Rafting
Aerial Ropes Courses
Please indicate if you have had experience working with people with any of the following disabilities: (check all that apply)
Blind/Visual Impairment
Cerebral Palsy
Spina Bifida
Developmental Disability
Spinal Cord Injury
Post Polio
Deaf/Hearing Impairment
Amputation
Brain Injury
Autism
Other
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Personal References * REQUIRED FOR FIRST YEAR VOLUNTEERS ONLY*
Please list those who are familiar with your character as it relates to working with individuals with disabilities and/or youth. We send letters of reference to each of the names listed.
Please be sure to list complete mailing or email addresses.
Name:
First Name
Last Name
Telephone:
Format: (000) 000-0000.
Mailing Address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email Address:
example@example.com
Name:
First Name
Last Name
Telephone:
Format: (000) 000-0000.
Mailing Address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email Address:
example@example.com
Name:
First Name
Last Name
Telephone:
Format: (000) 000-0000.
Mailing Address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email Address:
example@example.com
Certification and Acknowledgement
I certify that all information submitted in this application form, or any resume, interview or other information, is true and complete and that I have not knowingly withheld, or will I withhold, any information that would affect my volunteer application. I understand that Foresight Ski Guides is under no obligation to consider or reconsider this application at any time, and that acceptance of my application does not constitute an offer of employment or volunteer status. I also understand and agree that:
1. Inquiries may be made of my employer, previous employers or others who may have knowledge of me, or with investigative, or other private or governmental agencies that may have information concerning me and release all parties from any and all liability, claims or damages it
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made directly or indirectly from providing that information. I also agree to hold harmless Foresight Ski Guides, the officers, directors, employees and volunteers thereof.
2. I understand that if my application to participate as a volunteer at Foresight Ski Guides is accepted, my status as a volunteer may be terminated with or without cause or notice at my option or at the option of Foresight Ski Guides.
3. I understand that in signing this application, I affirm that the information I have given is true and correct.
(Date)
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Signature
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