IF
POSSIBLE DO NOT CONTACT DDA BY TELEPHONE. IT IS EASIER FOR US TO RESPOND
AND CONTACT YOU BY E-MAIL. YOU CAN GET A FREE E-MAIL ADDRESS AND HELP
USING E-MAIL VIA YOUR LOCAL PUBLIC LIBRARY, IF YOU DON'T HAVE E-MAIL.
E-mail us: DDAvolunteers@comcast.net |
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| Address:
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City:
Country:
Zip/mailing code:
Telephone or cell:
Fax:
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| Are
you representing a group of people wanting to volunteer? Yes
No
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Fill in only those that apply please:
Your age if you are only volunteer:
Representative/mean age of group of volunteers:
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| Are
you or your group: Male:
Female:
Mixed:
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| Time
you are available:
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Days
you are available:
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Write
in day,
month and year when you want to start your volunteer work:
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Write
in day,
month and year for completion
deadlines for your volunteer work:
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Click
only those that apply please:
Are you doing court ordered community service?
Are you doing volunteer work as part of school project:
Are you doing volunteer work for any other reason(s) which you thin
we should be aware? If so fill in details below:
If you are you doing court ordered community service:
1.
How many hours total do you need for this?
2. What is the
date by which you need to complete this work?
DAY:
MONTH:
YEAR:
Have
you volunteered in the past? If so please fill in details of other organizations
you have volunteered with below:
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MANDATORY:
Please write in the County and State in
which the offense for which you are court
ordered to do volunteer service occurred:
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MANDATORY:
Please write in the specific court
that ordered you to do volunteer
service, and the date of this order:
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MANDATORY:
Please write in the name of the person or probation officer
in Community Corrections who is supervising your community
service and also write in the contact info,
inclusive of phone, fax and e-mail for this person:
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MANDATORY:
Please write in ANY OTHER PROBLEMS YOU HAVE
THAT COULD IMPACT ON YOUR VOLUNTEER SERVICE AND
STATE ANY SPECIAL NEEDS YOU WOULD LIKE OUR
ORGANIZATION TO PROVIDE TO ASSIST
YOU WITH YOUR VOLUNTEER SERVICE:
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We
need the above information to expeditiously, safely and effectively
provide good and interesting volunteer opportunities for offenders,
access risk, and protect all parties inclusive members and the
community.
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Your
experience:
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Your
availability including days of the week and times each day that you are
available, transportation, and any other scheduling requirement:
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Do
you have a pick-up or van to use for transportation/volunteer
work when volunteering: Yes
No
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Do
you have health insurance that covers you for any accidents that may
occur when volunteering: Yes
No
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Other
info about you, e.g. volunteer work preferred, and other: communication/response:
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Information
Required/Requested:
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CLICK
HERE TO READ ALL SPECIFIC TERMS AGREED TO BY SUBMITTING
THIS FORM - RELEASE AND WAIVER OF LIABILITY
By
completing this form do you agree iN ADVANCE TO WAIVE ALL CLAIMS AGAINST
DDA regarding
all volunteer work , in all aspects and respects, done for Diabetics/Disabled
Anonymous:
Yes
No
CLICK
HERE TO DOWNLOAD YOUR COPY OF THIS RELEASE AND WAIVER
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CLICK HERE TO READ
ALL SPECIFIC TERMS AGREED TO BY SUBMITTING
THIS FORM - CONFIDENTIALITY AND NON-DISCLOSURE
By
completing this form do you agree in advance to complete/absolute confidentiality
regarding
all volunteer work , in all aspects and respects, done for Diabetics/Disabled
Anonymous:
Yes
No
CLICK
HERE TO DOWNLOAD YOUR COPY OF THIS
CONFIDENTIALITY AND NON=DISCLOSURE AGREEMENT
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Is
this communication urgent? Yes
No
Date response needed by: DAY:
MONTH:
YEAR:
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BY SUBMITTING THIS
FORM YOU AGREE TO ALL THE TERMS OF THE
LIABILITY WAIVER AND CONFIDENTIALITY SHOWN IN
LINKS AND DOWNLOADS OF AGREEMENTS IN FULL
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