Name
*
First Name
Last Name
Birthdate
*
MM
DD
YYYY
Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Email Address
*
Primary Phone Number
*
(###)
###
####
Preferred Method of Contact
What project are you interested in?
Landscaping
Childcare
Remodel
Other
How did you hear about us?
Reasons for Volunteering
Check All that Apply
Please understand that we will ask for a minimum of 20 hours.
Please list the School/Institution you are completing this for.
Please list the Class/Program. Note, we will ask for your learning objectives/syllabus.
How many hours?
Date needed by?
What documention do you need?
What are you willing to do with the Family Support Center:
Please Mark All that Apply
Do you have any special skills or qualifications?
Do you fluently speak a language other than English?
Please List All Languages and if you Can also do Written Translations
Do you have any certifications or licenses?
Such as: CPR, First Aid, Food Handlers, CERT, CDA, IT, RN, etc.
Tell us about your hobbies and/or interests!
This helps in finding a meaningful volunteer project that fits your interests.
What type of a volunteer schedule are you looking for:
Which mornings are you available?
Anytime before Noon.
Please Mark ALL that Apply.
Which afternoons are you available?
Anytime between Noon & 5:00PM
Please Mark ALL that Apply.
Which evenings are you available?
Anytime between 5:00 & 8:00PM
Please mark ALL that apply.
Name
First Name
Last Name
Relationship to You
Phone 1
(###)
###
####
Volunteer Placement
*
Due to the vulnerable population we serve, the Family Support Center reserves the right to deny any application for volunteering for any reason. Additionally, based on availability and support needed at each location, you may not be able to volunteer at the exact location you are most interested in.
Volunteer Dress Code
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We ask that you dress appropriately for working in an office and with young children. Our primary objective is to have all employees and volunteers project a professional image while taking advantage of more casual and relaxed clothing. Please no provocative or inappropriate clothing and accessories, or anything that would reflect poorly on the Family Support Center. Regardless of the item, it is essential to avoid wearing anything to work/volunteer that is worn, frayed, soiled/stained, see-through, excessively tight fitting, revealing, or inappropriate. When working directly with the children you are allowed to wear clean jeans and athletic shoes. For safety concerns, flip-flops and open toed shoes are not acceptable in the daycare and nurseries; you must wear closed toe shoes.
Drug Free Workplace Policy
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As required by Federal Law, the manufacture, distribution, possession or use of a controlled substance, other than by prescription of a health care worker licensed to prescribe the same is prohibited on the premises of all Family Support Center facilities or in any setting in which the volunteer is engaged in work-related duties under FSC auspices. As a condition I will abide by the above terms and notify his/her supervisor in writing of any conviction for a violation of any criminal drug statue occurring in the workplace no later than five (5) calendar days after the conviction. In the event of a conviction, appropriate personnel action will be taken. The personnel action imposed will be at the discretion of the Family Support Center.
Condfidentiality Policy
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I agree to safeguard the client’s rights of confidentiality. No information or photographs will be shared outside the agency without a signed release. The identity of all children in the Crisis Nursery, and all the women and children in the Life Start Village will be confidential.
This verifies that I have received and read a copy of the Family Support Center Drug Free Workplace Policy and the Confidentiality Policy and that I agree to the terms. The information I have given is true and correct to the best of my knowledge.
*
Please type your name again, verifying that you have read this.
First Name
Last Name
Would you like to receive our Newsletters to stay up to date on all opportunities?
Thank you!
You will be contacted soon.
If you have any questions in the meantime, please contact our volunteer coordinator, Melanie Urmston at 801-955-9110 x102 or melanie.urmston @familysupportcenter.org .
Thank you for your desire to help us further our mission! We are excited to have you join our volunteer family!