Volunteer Information

Our Kids Count Volunteer Application

Vision: For all individuals to be nurtured and supported by a caring and inclusive community.

Mission: To empower individuals to build stronger families and inclusive communities by enhancing their lives through personal growth and development.

*Please ensure you complete the application by clicking submit TWICE.*

* Required Fields

GENERAL INFORMATION

Please complete all fields:

First Name

Last Name

Address

Address 2

City

State/Province

Zip/Postal Code

Home Phone

Cell Phone

Work Phone

Date of Birth

Emergency Contact: Name

Relationship with Emergency Contact

Contact's Home Number

Contact's Cell Number

PREVIOUS VOLUNTEER/WORK EXPERIENCE

Please complete:

If you unsure of your exact dates, please use the first day of the month.

Organization

Position

Start Date (mm/dd/yyyy)

Finish Date (mm/dd/yyyy)

Organization

Position

Start Date (mm/dd/yyyy)

Finish Date (mm/dd/yyyy)

Organization

Position

Start Date (mm/dd/yyyy)

Finish Date (mm/dd/yyyy)

REASONS FOR VOLUNTEERING

Please check all that apply:

Other

AGREEMENT & E-SIGNATURE

Please check and sign below

I understand that for volunteer positions of trust, successful applicants (18 years & over) may have to undergo a Police Records Check

I give permission to use any photos or videos taken during volunteering for promotional purposes. This is including but not limited to: Our Kids Count website, Our Kids Count social media pages, and promotional print materials.

I understand that any breach of confidentiality regarding any information about participants is a cause for dismissal.

I understand & agree to comply with my roles & responsibilities of my volunteer position as stated in the Volunteer Handbook.

I hereby waive liability of any and all claims against Our Kids Count, its sponsors and partners for personal injury, death or property damage which may directly result from my volunteering with Our Kids Count.

E-Signature

Date (mm/dd/yyyy)

Privacy Policy
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