Interest in Volunteering Form
Volunteer Profile: The climate in the United States at this point in history is such that a concern about potential liability is raised in every sector of American life, including the Church. This is coupled with a heightening awareness of a responsibility to ensure that those who act in the name of the Church would never violate basic Christian decency. In order to protect the Church, those whom it serves and those who serve it, we ask you to complete the form below. A physical copy of each application for volunteer service will be kept on file for one (1) year following the termination of the volunteer's service, and an electronic copy of the application will be kept for (50) years following the destruction of the physical document.
Please complete this form if you are interested in becoming a Catholic Charities Atlanta volunteer. Once you complete the form click the "CONTINUE" button at the bottom of the page.
Contact Information
Full Name
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First Name
Middle Name
Last Name
Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Home Phone
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Area Code
Phone Number
Cell Phone
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Area Code
Phone Number
E-mail
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Volunteer History
Please list your last three volunteer activities, starting with the most recent.
References
Please list three non-family members who are familiar with your character.
Why are you interested in volunteering for Catholic Charities Atlanta?
Tell us about yourself (i.e. your interests, special skills, what you are looking for in a volunteer opportunity-- anything you want to share!)
Personal Information
a. Have you ever been charged with, arrested for, or convicted of a crime other than a minor traffic violation?
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Please Select
Yes
No
If yes, explain fully the circumstances. (Such charge or conviction may be relevant if job related but does not bar you from volunteering.)
b. Have you ever been the subject of an investigation involving an allegation of sexual abuse?
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Please Select
Yes
No
If yes, please explain:
c. Has a civil or criminal complaint ever been filed against you alleging physical abuse or sexual abuse?
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Please Select
Yes
No
If yes, give a short explanation of the complaint. (Please indicate the date, nature, and place of the incident leading to the complaint, where the complaint, where the complaint was filed, and the disposition of the complaint.)
d. Have you ever terminated your employment or had your employment terminated for reasons relating to allegations of physical abuse by you?
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Please Select
Yes
No
If yes, please give a short explanation of the allegations, the disposition of the allegations, and your employer at the time, including your employer's name, address and telephone number.
e. Have you ever received any medical treatment, physical or psychological, for reasons involving physical abuse or sexual abuse by you?
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Please Select
Yes
No
If yes, give a short description of the treatment, including date(s), nature and location(s), identifying the treating physician with name, address, and telephone number.
Skills- we are always looking for talented help!
Bilingual/Multi-lingual
Companion
Crafts/Sewing/Knitting
Funding/Development
Homemaking
Maintenance/Repair
Organizing/Sorting
Web Design
Cleaning
Computer Skills
Driving
Gardening
Journalism/Writing
Medical
Public Speaking
Teaching
Clerical
Teaching English Language
Group Facilitation
Legal
Mentoring
Sign Language
Tutoring
General clerical
Marketing/social media
Graphic Design
Videography
Photography
Other
Availability: Please indicate the days and times you are usually available to volunteer. Please note that CCA is NOT open on the weekends.
Monday
Tuesday
Wednesday
Thursday
Friday
Morning
Afternoon
Evening
After looking at the CCA website, do you see a particular area in which you would like to get involved? Please explain.
Assignment Preference(s)
Family Stabilization Program-Chamblee
No Preference
Refugee Services-Northlake
Teaching English as a Second Language
Central Office- Smyrna
What kinds of email are you willing to receive
Volunteer Notices
CCA's Electronic Newsletter
Important:
All volunteers undergo a background and reference check. Those who provide direct services to children and/or the elderly MUST also compete a 3-hour safe environment training.
I Agree
I understand and agree that submitting this application form does not automatically register me as a Catholic Charities Atlanta volunteer, and that there may be certain qualifications I must meet, including the acceptance of established volunteer policies and procedures before I may begin volunteering. I understand that if I use my personal automobile to and from my volunteer work station, I will have a current operator's license and arrange to keep in effect automobile liability insurance equal to or greater than the minimum required by the state.
By Submitting this form, I attest that the information I have provided on the form is true and accurate
I agree.
I do not agree.
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Confidentiality Statement
I, an unpaid volunteer of Catholic Charities of the Archdiocese of Atlanta, Inc., understand that through my work with the agency and it's clients I may handle, observe, collect and/or otherwise be exposed to sensitive and confidential client and/or employee information. I agree to respect the confidentiality of this information at all times and to refrain from disclosing such information to any unauthorized individual without the express written permission of the client/employee and the express permission of the employee responsible for my supervision. I agree to treat all clients of Catholic Charities of the Archdiocese of Atlanta, Inc. with respect and caring, maintaining appropriate boundaries and relationships with them at all times. I also understand that violation of this agreement may result in the termination of my volunteer relationship with the agency.
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Waiver and Release of Liability
I hereby acknowledge that my voluntary participation with Catholic Charities of the Archdiocese of Atlanta, Inc. ("Catholic Charities") may involve risks of property damage, illness, and bodily or personal injury that could result in death. Potential risks may include, but are not limited to: >Injuries due to trips or falls >Exposure to contagious diseases, especially if working with the children and/or in inclement weather conditions >Any other risks that may be associated with the program for which I volunteer. I HEREBY ASSUME ANY AND ALL SUCH RISKS. Furthermore, I will immediately notify the person in charge of the program if, any time, I feel that i have been placed in physical danger, or if for any reason I feel uncomfortable at the program site.I am voluntarily participating as a volunteer for Catholic Charities with a full understanding of these risks, and I assume and agree to accept any and all risks to my safety and security during the course of participating as a volunteer. Furthermore, I acknowledge and agree that as a volunteer, I am not entitled to, and shall not receive, any compensation of any type for my services. For the sole consideration of the Catholic Charities allowing me to participate in any of their programs, I hereby release and forever discharge and hold harmless Catholic Charities of the Archdiocese of Atlanta, Inc. and their officers, agents, affiliated entities, employees, and other volunteers (the "Releasees") from any and all liability claims, demands, rights and courses of action of whatever kind, arising from or by reason of any personal injury or property damage or otherwise, or the consequences thereof, resulting from or in any way connected with my participation in the program or service as a volunteer. I further covenant and agree that for the consideration stated above I will not sue any of the Releasees for any claim for damages arising or growing out of my voluntary participation in the program. I certify that I am at least 18 years of age and have read and understood the above before voluntarily signing.
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