Volunteer CONTACT INFORMATION: Today's Date First Name Last Name Address Suite/Unit City State Zip Code Home Phone Cell Phone Birth Date Email Emergency Contact Name Phone Number Skills/Interests/Education: AVAILABILITY: Weekdays: Mornings Afternoons Evenings Weekends: Saturday Sunday Employed: Full Time Part Time Retired Student: Full Time Part Time How would you like to volunteer with Switchpoint? Daily Weekly Monthly Special Events Whenever Needed How many hours would you like to volunteer? Please contact me to discuss my availability (Please check the volunteer areas you are interested in volunteering for.) Volunteer Opportunity Description Administrative Support Assist our staff with data entry, filing and other office duties as needed. Donation Drive Coordinator Organize a donation drive for items needed by SPAN. Sort/Organize and Price Donations Sort, organize and price donations. Computer Learning Assistants Teach basic computer skills to individuals who are seeking employment. Monitor the computer lab to keep individuals on task. Teaching Staff Teach Drop out students up to 18 years IT TAKES ALL OF US Release of Liability I hereby fully and forever waive, release and relinquish and all claims, demands and actions whatsoever that I may have or may accrue to me against SPAN, officers, agents, volunteers and employees arising out of this activity and/or any volunteer activity associated with or connected with this activity. Furthermore, I agree to indemnify and hold harmless and defend SPAN, from any and all claims and actions resulting from injuries, damages and losses sustained by me arising out of, connected with or in any way associated with this volunteer position.I have read this agreement and fully understand its content and sign it of my own free will. I further certify that I am (18) years of age or the parent/legal guardian of a minor participant. Statement of Confidentiality As condition of being involved with persons seeking assistance from SPAN , I agree to keep confidentialany information shared with me. I understand that no information concerning clients shall be released to other agencies or persons without signed, written consent of those involved.I recognize that the unauthorized release of confidential information may make me subject to civil action.I further understand that violation of this agreement is grounds for termination of my service. Printed Name: Date:
