VOLUNTEER REGISTRATION FORM

volunteer service title

Please select one option

Hours Required:

Please explain the nature of the offense

Hours Required:

Preferred Day(s):

Preferred Area(s):

PERSONAL INFORMATION

First Name *

Last Name *

Email *

Phone *

Date of Birth

M

D

Year

Gender

Address 1 *

Address 2

City *

State *

Zip *

Emergency Contact

Contact Phone

Relationship

Certifications

Please upload all certifications

Add another certification +

Do you have a Food Handler’s Permit?

Food Handler's Permit Exp Date

M

Year


Are you CPR certified?

CPR Certification Exp Date

M

Year


Are you First Aid certified?

First Aid Certififcation Exp Date

M

Year

Why do you want to volunteer at the Issaquah Food and Clothing Bank? Any specific goals?

What skills and knowledge are you willing to share with the Issaquah Food and Clothing Bank?
Please check all boxes that match your skills or interests.

Confidentiality Statement: I understand that all information on this form is voluntarily supplied and may only be used and disclosed in a professional manner. I understand it is the policy of Issaquah Food and Clothing Bank to regard all information (both written and verbal) pertaining to staff, volunteers and clients served as confidential. Furthermore, I understand and agree to comply with the confidentiality statement as it pertains to information I may learn or be entrusted with as a volunteer in the community.

Initial Here *

Drug Free Statement: Issaquah Food and Clothing Bank is committed to providing a drug free, healthy, safe and secure work environment for employees and volunteers. Each employee and volunteer is expected and required to report to work in an appropriate mental and physical condition to perform his/her assigned duties. Issaquah Food and Clothing Bank prohibits the use, possession, or sale of illicit drugs in the workplace or when conducting agency business. Issaquah Food and Clothing Bank requires its employees and volunteers to be free from illicit drugs and from the influence of alcohol where the potential for impairment or unsafe job performance is indicated.

I understand this policy and agree to comply with the statement.

Initial Here *

Please sign this application form: This affirms you have read and understand the Guiding Principles, the confidentiality, drug free, and insurance statements on this form and that all of the above information is true to the best of your knowledge.

Signature *

Parent/Guardian Signature is required for those under 18: I am the custodial parent/guardian of the above listed person. I give permission for him/her to participate in volunteer activities. I hold harmless Issaquah Food and Clothing Bank for any injury or other situations that may arise from my child’s choice to serve as a volunteer. I understand that in some volunteer situations parental or adult supervision may be required in order for my child to participate. I agree to hold Issaquah Food and Clothing Bank harmless, and give my child permission to participate in volunteer activities.

Signature