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Required fields are marked with an asterisk (*). First Name: *
Middle Initial:
Last Name: *
Legal name (if different from above):
Date of Birth: *A valid date as MM/DD/YYYY (for example: 11/30/2015)
Street 1:
Street 2:
City:
State:CA OR WA
Zip:
Primary Phone: *For example, 123-456-7890
SMS (text) messaging:
You may opt-in to receive SMS (text) for ST VINCENT DE PAUL SOCIETY OF LANE COUNTY volunteer activities, including shift reminders and cancellations.
Select:
Opt-in: I consent to opt-in to receive SMS (text) messages from ST VINCENT DE PAUL SOCIETY OF LANE COUNTY
Opt-out: Do not send SMS (text) messages from ST VINCENT DE PAUL SOCIETY OF LANE COUNTY to my mobile device
To opt-out, reply STOP to any SMS message OR update the SMS opt-in setting in your profile.
Cell Phone (If Diffrent from Primary):
St. Vincent de Paul Society of Lane County has permission to include my mobile number in automated text messages. Msg&Data rates may apply. Frequency varies. "STOP" to unsubscribe. Yes No
Consider becoming a Vinnie's Reservist.
Reserve Volunteers are placed on an outreach list and when special, short-term, or emergency volunteer projects and opportunities come up we will reach out to see who can come and help out. These projects usually require a short commitment of a single day to a week or two at most but are often among our most vital volunteer needs. Whether it's helping a department process an unexpected surplus, helping get things back in order after an emergency, or helping with prep for major Vinnie's events, these projects and events often have a far-reaching effect on operations across the organization as a whole.
Would you like to be on the outreach list for unique volunteer projects?Yes No
What type of projects would you be interested in helping with? Short-term (1 - 2 week) Priority Projects Backup Store Support General Event Setup First Place Family Center Events Seasonal Events One-off Projects Other
Please Elaborate:
Are you currently receiving assistance from SVdP Programs? (If yes, you cannot vounteer with a program directly affiliated with the one you are reciving assistance from)
Languages spoken other than English:
How did you hear about our volunteer opportunities? SVdP Handouts (Flyers; Pamphlets; Mailings) In-Store Social Media Word of Mouth Youth Program Sheriffs Office Browsing for Community Opportunities Other
Please Explain:
Please provide skills, experience, interests, or background you feel may be helpful or relevant to placing you in a beneficial volunteer opportunity or internship.
Are there any physical accommodations needed?
Are you signing up after being referred to this application by an SVDP staff member?Yes No
Name of staff member?
Type of Project?
Please list any types of volunteer work you would prefer and/or specific locations where you are interested in volunteering.
Please let us know if you are volunteering with a program or to fulfill any required hours. *Court-appointed Youth Program Return to Work Program Other N/A
Name of organization/program:
Program Contact:
Program Contact Email:
Program Contact Phone:
Number of hours needed:
By what date are hours due:A valid date as MM/DD/YYYY (for example: 11/30/2015)
Further Notes
EC First Name: *
EC Last Name: *
EC Primary Phone: *
EC Email Address:
EC Relationship:Spouse Father Mother Sibling Son Daughter Significant Other Neighbor Supervisor Co-Worker Friend Son-In-Law Daughter-In-Law
Disclaimer
Statement of Release
I, the undersigned, hereby release St. Vincent de Paul Society of Lane County, Inc. (SVdP) from all liabilities in connection with any tasks performed as a volunteer and give permission to include my photograph in any of the agency's publications. I authorize SVdP to enter my name and contact information into their mailing list so that I can receive their publications.
By signing the "digital signature" box below, I understand that a criminal background check may be obtained to verify the information I have provided on this application. I understand that in the event of an accident or injury while volunteering for SVdP, my health and vehicle insurance is primary.
Volunteers and prospective volunteers are expected to adhere to the same confidentiality standards as SVdP staff. Confidentiality includes disclosure of information about sexual orientation, religion, disability, race, color, age, creed, or personal history. Information regarding yourself, clients, staff, and other volunteers is not information that should be discussed with others within the agency or elsewhere.
I hereby authorize St. Vincent de Paul Society of Lane County, Inc. to verify all information contained in this application with any references to disclose any and all information to SVdP. I release all such persons from liability that may result of arise from the collection of all such evaluations or information or its consideration of my application.
Check here to show you accept the terms stated above. Enter your name here to serve as a digital signature:
Statement of Release
I, the undersigned, hereby release St. Vincent de Paul Society of Lane County, Inc. (SVdP) from all liabilities in connection with any tasks performed as a volunteer and give permission to include my photograph in any of the agency's publications. I authorize SVdP to enter my name and contact information into their mailing list so that I can receive their publications.
By signing the "digital signature" box below, I understand that a criminal background check may be obtained to verify the information I have provided on this application. I understand that in the event of an accident or injury while volunteering for SVdP, my health and vehicle insurance is primary.
Volunteers and prospective volunteers are expected to adhere to the same confidentiality standards as SVdP staff. Confidentiality includes disclosure of information about sexual orientation, religion, disability, race, color, age, creed, or personal history. Information regarding yourself, clients, staff, and other volunteers is not information that should be discussed with others within the agency or elsewhere.
I hereby authorize St. Vincent de Paul Society of Lane County, Inc. to verify all information contained in this application with any references to disclose any and all information to SVdP. I release all such persons from liability that may result of arise from the collection of all such evaluations or information or its consideration of my application.
Check here to show you accept the terms stated above.