Society for People's Awareness.

VOLUNTEER APPLICATION

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:

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