First Name: *  

Last Name: *  

Address 1: *  

Address 2:    

City: *          

State: *                      Zip: *

Home Tel: *    

Home Fax:   

Pager:          

Cell Phone: 

E-Mail: *     

Date of Birth: *    

Emergency Contact:

Emergency Phone:  

Place of Employment: *  

Full Time: *   Part Time: Other:

Work Phone:  Ext:

Supervisor:  

School:        

Counselor / Teacher:

How did you hear about ComputerCorps? *

Why do you want to volunteer? *
 

Have you volunteered before?
Yes: No: If Yes, please give details:

Please provide a brief description of your work history: *
 

What type of computer do you have? *
 

Check Type(s) of Volunteer Work Desired *

Technical

Trainee: ..............................
Computer Technician:.........
Web Page Design: ..............
Web Based Editorials: ........
Programming: ....................
Software Installation: .........
Computer Repair: ...............
Graphic Design: ..................
Software Training: ..............
Monitor Repair: ...................
Computer Maintenance: ......
Computer Networking: ........
Forum and Chat SysOp:.......

Administrative

Telephone Calls: ................
Typing / Data Input: .............
Secretarial: .........................
Office Work: ........................
Public Relations: .................
Organizing: .........................
Fundraising: ........................
Bookkeeping: ......................
Advertising: .........................
Legal Work: .........................
Accounting: .........................

Facilities

Painting: .............................
Gardening: .........................
Janitorial Work: ..................
Misc. Labor Work: ..............
Driving Vehicles: ................
Cooking / Chef: ..................
Plumbing Work: .................
Electrical Work: ..................
Landscaping: .....................
Carpentry Work: .................
Warehouse Work: ...............

Days When Possibly Available (This is Not a Commitment)

Mon: Tue: Wed: Thu: Fri: Sat: Sun:

Personal and/or Business References:

#1 Reference Name: * 

#1 Reference Phone: *

#1 Reference Relationship: * 

#2 Reference Name: * 

#2 Reference Phone: *

#2 Reference Relationship: * 

#3 Reference Name:   

#3 Reference Phone:  

#3 Reference 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 volunteers

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? *
Yes:    No

Have you ever been convicted of a felony? *
Yes:    No

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.

By clicking the submit button, you acknowledge acceptance of the terms of our relationship, state that all information is true and that you are 18 years of age or older.