Long Term Volunteer Form

Applicant's Name *

First Name Middle Name Last Name

Date of Birth *

Date

Spouse's Name

First Name Middle Name Last Name

Date of Birth

Date

Address *

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

Email *

example@example.com

Phone Number *

- Area Code Phone Number

In Case of Emergency *

Name
E-mail
Phone	Phone
Relationship	Country

Describe when and how often you would like to volunteer: *

Please define expected arrival date, length of stay, If both you and your spouse will be volunteering, etc... *

RV details *

Make/Model
Utilities needed
Length/Width with slides	State / Province
Slides/Side of Slides	Country

Special considerations/accommodations Warm Beach Camp (WBC) should be aware of?

Skills, Training and Experience

What has been your "Life Occupation(s)?" *

Describe the experiences, skills, or qualifications which you believe especially fit you for you work at WBC: *

Briefly describe the type of work you'd like to do and which would best use your background and experience: *

List below all present and past employers beginning with your most recent:

Please include dates of employment

Skills

Please indicate your interest and/or level of expertise in the areas below.

Accomodations- General Cleaning, Bed making, Laundry

	1	2	3	4	5
Helper						Professional

Sewing/Mending

	1	2	3	4	5
Helper						Professional

Office- Computer Knowledge(Microsoft Office), Data Entry

	1	2	3	4	5
Helper						Professional

Food Service- Host, Set/Clear Tables

	1	2	3	4	5
Helper						Professional

Grounds- Weeding, Planting Flowers, Mowing, Pruning

	1	2	3	4	5
Helper						Professional

Construction- General Construction

	1	2	3	4	5
Helper						Professional

Wood Working/Finish Work

	1	2	3	4	5
Helper						Professional

Mechanical- Automotive, Small Engines, HVAC

	1	2	3	4	5
Helper						Professional

Horsemanship- General Stable Chores, Feeding, Leading, Riding Help

	1	2	3	4	5
Helper						Professional

Specific Skill not listed

Example- Welding, Music, Recreation, Teaching, etc...

Additional Comments:

References

Please include a character reference as well as a employment reference.

Reference 1:

Name

Phone Number

- Area Code Phone Number

E-mail

Reference 2:

Name

Phone Number

- Area Code Phone Number

E-mail

Mission

I understand that if I volunteer and if any statement herein is not true, I may be released immediately.

I understand that if I volunteer, I will be required to abide by all Camp policies, standards, and regulations.

I hereby authorize Warm Beach Camp and Conference Center to contact all prior employers and any references listed herein to verify all information provided and to obtain any and all information related to my character and past work performance. I further hereby release all references and prior employers from any liability for information provided in good faith.

I hereby affirm that I have carefully read and agree with Warm Beach Camp and Conference Center’s Statement of Faith and Mission, which can be found at https://www.warmbeach.com/mission. I understand that, if at any time I no longer agree with the Warm Beach Camp Statement of Faith or I exhibit conduct which is contrary to the Mission, or I fail to meet the minimum requirements of the position, I may be disqualified from volunteering.

I affirm that I have neither been convicted of nor am I the subject of, pending charges for any offense involving actual or attempted child abuse or sexual molestation in any jurisdiction.

I recognize that as a condition of my volunteering, I will be required to consent to Warm Beach Camp and Conference Center criminal records check from the Central Criminal Records Exchange or other appropriate federal and/or state law enforcement agency and I consent to do so, realizing the importance of promoting the Employer’s ability to protect its workers and those whom it serves.

Background Investigation Consent/Release of Liability

I hereby authorize Warm Beach Camp and Conference Center (the Camp) and/or its agents to make an independent investigation of my background, references, character, past employment, education, criminal or police 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 as a volunteer or for employment now, and if applicable, during the tenure of my volunteering or employment with the Camp.

I release the Camp 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.

I hereby affirm and acknowledge, by signing immediately below, that all of the information provided and all of my answers to the foregoing questions are true and complete, and that any misrepresentation or omission may be grounds for rejection or dismissal.

Signature *

Clear

Application for Long-Term Volunteering at Warm Beach Camp

Applicant Information