Volunteer Application with Background Check Copy
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- Gyles Mathews
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1 Volunteer Application with Background Check Copy Last Name First Name Address Street Apt City State /Zip Code Country U.S. Other-Please Specify Contact Phone Number Address Date of Birth / / Month Day Year Social Security # - - Driver s License # Provide Guardian s if under 18 DL State: Employer How did you hear about West Avenue Compassion? Do you need to limit your physical activities? Yes No If Yes, please specify as certain limitations may determine what opportunities are available to you. *WEST AVENUE COMPASSION understands the importance of keeping personal information private and will not sell your personal information.
2 Volunteer Application with Background Check Copy I give permission for WEST AVENUE COMPASSION (also know as WAC) or First Church of the Nazarene (also know as SAFNAZ) to obtain background check information through the First Advantage. The background check, as received from the reporting agency, may include arrest and conviction data as well as plea bargains and deferred adjudications and delinquent conduct committed as a juvenile. I understand that this information will be used, in part, to determine my eligibility for a volunteer position with this organization, but will not necessarily preclude it. I also understand that as long as I remain a volunteer here, the background check may be repeated at any time. I understand that I will have an opportunity to review the background check as received by WEST AVENUE COMPASSION (also know as WAC) and a procedure is available for clarification if I dispute the record as received. WEST AVENUE COMPASSION (WAC) or San Antonio First Church of the Nazarene (SAFNAZ) has the right to terminate the application process or volunteer commitment at any time. Publicity/Photography Release I give WEST AVENUE COMPASSION (WAC) or First Church of the Nazarene (SAFNAZ) the authority to use and publish in any locality the film, recordings, and/or photographs taken of me in whole or part and authorize use of my name, if known, in any form of advertising or publicity. I understand that any pictures or other media taken by WEST AVENUE COMPASSION (WAC) or First Church of the Nazarene (SAFNAZ) become property of WEST AVENUE COMPASSION, WAC or First Church of the Nazarene (SAFNAZ) Waiver of Liability Agreement for Volunteers That as a volunteer, I will not be covered for personal injury or personal liability through WEST AVENUE COMPASSION (WAC) or FIRST CHURCH OF THE NAZARENE (SAFNAZ) That WEST AVENUE COMPASSION (WAC) or FIRST CHURCH OF THE NAZARENE (SAFNAZ) and its employees will not be held responsible or liable by me in any way whatsoever as a result of any incident which might be construed to adversely affect my health, safety or welfare. That I knowingly waive all rights to hold WEST AVENUE COMPASSION (WAC) or FIRST CHURCH OF THE NAZARENE (SAFNAZ) liable as a result of any incident. That I fully disclose to the volunteer coordinator or site coordinator information about my physical and mental health which might affect my performance as a volunteer, and I acknowledge full responsibility for any consequences of my failure to disclose that information I AGREE TO THESE TERMS AND CONSENT TO A BACKGROUND CHECK I AM 18 OR COMPLETING THIS APPLICATION FOR MY CHILD Signature and Date Guardian Signature If under 18 years of age and Date *WEST AVENUE COMPASSION or FIRST CHURCH OF THE NAZARENE understands the importance of keeping personal information private and will not sell your personal information.
3 Volunteer Application with Background Check Copy Special Areas of Interest (check all that apply): Choice Pantry Food Pantry Sorting & Packing Food Pantry Admin. Services (based on WAC s needs) Food Pantry Client Services Senior Distribution Set up/tear down of classrooms Clothing Pantry Donation Pick Ups Availability (check all that apply): Morning Weekdays Afternoon Weekends Community Garden Special Events Job Bank Education Programs Nurses Station-Please briefly specify qualifications Child Care-Please briefly specify qualifications Evenings A monetary donation is suggested to help cover the cost of the operations and different programs. We are a 100% volunteer organization with a weekly budget of $ per week from donors like you. *WEST AVENUE COMPASSION understands the importance of keeping personal information private and will not sell your personal information.
4 Monday Choice Pantry When: Monday 10:00-12:00 *Must be able to lift 10lbs for more Monday 12:00-2:30 *Help clients shop and check out or groups (Maximum 8) 18 years of age and up must complete an application and background check Job Description: Assist WAC staff in unloading food from truck, set up produce/bread, assist clients in shopping, restock shelves and clean up Tuesday Food/Clothing Pantry When: Tuesdays 9:00 to 4:00. Hours can vary due to volunteer needs. or groups (Maximum 15) 18 years of age and up must complete an application and background check prior to volunteering Job Description: Assist WAC staff in unloading food from trailer, set up tables, package food for distribution, help distribute, clean up, carry out, organize clothes to distribute. Dress Code-Modest, comfortable clothes with close-toed shoes MUST BE ABLE TO LIFT 10lbs or more Clothing Pantry When: Monday Evenings 6:30-8:00 or groups (Maximum 8) 18 years of age and up must complete an application and background check Job Description: Assist WAC staff in sorting and hanging up donated clothing Dress Code-Modest, comfortable clothes with close-toed shoes
5 Senior Distribution When: 1st Thursday of each month from 9:00 to 2:30. or groups (Maximum 15) 18 years of age and up must complete an application and background check prior to volunteering Job Description: Assist WAC staff in unloading food from trailer, set up tables, package food for distribution, help distribute, carry out and clean up. Work is both inside and outside. Must be able to handle the weather. Bring Water Dress Code-Modest, comfortable clothes with close-toed shoes *MUST BE ABLE TO LIFT 10lbs or more Community Garden Where: WAC s Community Garden at SAFNAZ When: 4th Saturday of the month at 9:30 and groups (Maximum of 4) Qualifications: Be able to bend and lift up to 10 lbs. Job Description: Help Community Garden Clients to weed, pick vegetables, mow etc. Donation Pick Up 1 Where: Chicago Bagel (Vance Jackson & Wurzbach)/Lenny s Alon Center/ Raising Cane s off of Broadway When: Friday AM Job Description: Pick up donations from the three locations mentioned up above and deliver them back to the non-profit at SAFNAZ
6 Donation Pick Up 2 Where: Lenny s Alon Center/Raising Cane s off of Broadway When: Tuesday AM Job Description: Pick up donations from location mentioned up above and deliver them back to the non-profit at SAFNAZ Donation Pick Up 3 Where: Whole the Vineyard When: Monday OR Tuesday OR Both 8:00-10:00 AM Job Description: Pick up donations from location mentioned up above and deliver them back to the non-profit at SAFNAZ Donation Pick Up 4 Where: Blanco and West Avenue When: Saturday OR Sunday OR Both -AM Job Description: Pick up donations from the three locations mentioned up above and deliver them back to the non-profit at SAFNAZ Donation Pick Up 5 Where: Wurzbach and I-10 When: Sunday AM Job Description: Pick up donations from location mentioned up above and deliver them back to the non-profit at SAFNAZ
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