Volunteer Application Form

Full Name *

First Name Middle Name Last Name

Primary Phone *

Alternative Phone

E-mail

Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code

Date of Birth *

- Month - Day Year

Languages

Areas of Interest (select all that apply)

Driver (Personal Vehicle) Van Driver Companion Homemaker/Grocery Shopping Handyman/Chore Office

Days and times you are available to volunteer *

Please provide 3 Personal References *

Include name, phone, and email for each reference.

How did you hear about us? *

Summarize why you'd like to volunteer *

Emergency Contact *

First Name Last Name

Phone *

Relationship *

I agree to protect the confidentiality of all information pertaining to any Neighbor Network (NN) member, non-member or other volunteer associated with NN. I agree to follow and adhere completely to the Neighbor Network’s program’s rules and guidelines. My application submission acknowledges my agreement to adhere to this confidentiality policy.
I attest that my involvement and membership in NN, a project of the Colorado Nonprofit
Development Center (CNDC) is fully voluntary and that I can decline participation at any time by contacting the office. I hereby release NN, CNDC, its staff, the board of directors, associates, clients and volunteers from all liability for any injury, medical expenses or damages related to services provided and/or completed by NN and its volunteers. I indemnify and hold harmless NN, CNDC, its staff, board of directors, associates, clients and volunteers from all claims, demands, losses, cause of action, lawsuits, judgment, including attorneys’ fees and costs, arising out of or
relating to, activities related to services provided by the organization, Neighbor Network.
I consent to undergo a background check by Verified Volunteers. I will have the opportunity to contribute to the cost of the background check but am not obligated to do so. I will own this background report and may share it with other nonprofit organizations if I so choose. The background check results will be kept confidential.

Agreement: By submitting this application, I certify that I have read and agree to the information above and confirmed the accuracy of information provided.

Thank you for making a difference!