ComputerCorps_ä

www.computercorps.org

Volunteer Application

Last Name (Printed):

First Name:

Address:

City:

ST:

Zip:

Home Phone:

Fax Phone:

Pager:

Cell Phone:

E-Mail:

DOB:

SS#:

Emergency Contact:

Emergency Phone:

Place of employment:

[ ] Full Time

[ ] Part Time

Work phone:

Supervisor:

School:

Counselor / Teacher:

How did you hear about ComputerCorps?

Why do you want to volunteer?

Have you volunteered before?

[ ] No

[ ] Yes

Please give details:

Please provide a brief description of your work history:

Do you have a computer?

[ ] No

[ ] Yes

What Type?

Type(s) of Volunteer Work Desired:

Technical

Administrative

Facilities

[ ] Trainees

[ ] Telephone Calls

[ ] Painting

[ ] Computer Technicians

[ ] Typing / Data Input

[ ] Gardening

[ ] Web Page Design

[ ] Secretarial

[ ] Janitorial Work

[ ] Programming

[ ] Office Work

[ ] Misc. Labor Work

[ ] Software Installation

[ ] Public Relations

[ ] Driving Vehicles

[ ] Computer Repair

[ ] Organizing

[ ] Cooking / Chef

[ ] Graphic Design

[ ] Fundraising

[ ] Plumbing Work

[ ] Software Training

[ ] Bookkeeping

[ ] Electrical Work

[ ] Monitor Repair

[ ] Advertising

[ ] Landscaping

[ ] Computer Maintenance

[ ] Legal Work

[ ] Carpentry Work

[ ] Computer Networking

[ ] Accounting

[ ] Warehouse Work

Volunteer Application Continued (Page 2 of 3):

Days and Hours When Possibly Available (This is not a commitment):

Days:

[ ] Mon

[ ] Tue

[ ] Wed

[ ] Thu

[ ] Fri

[ ] Sat

[ ] Sun

Times:

Personal and/or Business References:


Reference Name:	Phone:	Relationship:

Reference Name:	Phone:	Relationship:

Reference Name:	Phone:	Relationship:

Volunteer Rules and Guidelines:

The ComputerCorps mission is to help others and the community. All volunteer duties are to be performed with the spirit of teamwork, co-operation and kindness. Volunteers not abiding by these rules will be asked to leave.

1. Your conduct must be in a respectful and courteous manner at all times.

2. Foul language, disruptive behavior or gossip will not be tolerated.

3. Friends are not to be on the property unless front office is notified.

4. Any form of illegal activity (alcohol, drugs, theft, etc.) will terminate volunteer.

5. ComputerCorps adheres to the strictest software anti-piracy policies.

6. Software is not to be copied except for backup purposes.

7. All volunteers must log in upon arrival and out prior to departure.

8. All volunteers must wear the appropriate nametags or ID badges.

9. For security and control purposes, volunteers may be required at any time to provide a copy of their drivers license and/or photo identification and to have their picture taken. Reference and background checks will be made prior to acceptance of volunteer application.

Additional Guidelines for Volunteers under the age of 18 years:

1. On school days, Student Volunteers may volunteer only during non-class hours.

2. Any “F” on a report card may put the volunteer on suspension until grade is improved.

3. Any detention, depending on severity, may terminate or suspend volunteer.

4. Disrespect shown toward parents and/or teachers may suspend volunteer.

Volunteer Application Continued (Page 3 of 3):

Waiver of Liability & Disclaimer:

I acknowledge that by participating in different volunteer duties the risk of physical injury is present. I further acknowledge that the programs of ComputerCorps are primarily administered by individuals who volunteer their time rather than paid professionals. In consideration for ComputerCorps accepting the above named individual & permitting the voluntary participation of said individual in its programs, I hereby release, discharge, & hold harmless ComputerCorps, its employees, volunteers & any other entities and/or representatives from any claims arising out of or relating to any physical injury that may result to said individual while participating in ComputerCorps sponsored events, including any physical injury caused by the negligence of any supervisors while performing his or her duties during any functions. I further acknowledge that I am only a volunteer and that any benefits or perks that I receive as a result of my participation do not constitute an employee employer relationship. I acknowledge that I have read and fully understand the above and that the information that I have provided is true and correct.


Have you ever been arrested?	[ ] No	[ ] Yes

Have you ever been convicted of a felony?	[ ] No	[ ] Yes

If Yes to either of the above, give details:



At various times ComputerCorps and its volunteers work with children, sensitive data and costly computer components. Because of this work, it is often necessary to run background checks on the volunteers with local, state and / or federal agencies. Volunteers may also be requested to have their picture and / or fingerprints taken and to provide a copy of their picture ID for ComputerCorps files. All information provided will be kept as confidential as possible.

Applicant Signature:

Date:

Printed Last Name:

Printed First Name:

** For Applicants Under The Age of 18, Parent / Guardian Waiver & Disclaimer Required **

I have read and fully agree with the above information provided by ComputerCorps and the applicant hereby gives my permission for the above named individual to apply for a volunteer position.

Parent / Guardian Signature:

Date:

Printed Last Name:

Printed First Name: