Volunteer Application Volunteer Information: * First Name: Required * Last Name: Required * Email: Required * Street 1: Required Street 2: * City: Required * State / Province: Required AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY AS FM GU MH MP PR PW VI AA AE AP AB BC MB NB NL NS NT NU ON PE QC SK YT None Required * ZIP / Postal Code: Required * Phone Number: Required Gender: Male Female Required Date of Birth: Date of Birth: Month Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year 1900 1901 1902 1903 1904 1905 1906 1907 1908 1909 1910 1911 1912 1913 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 2028 Please check this box to receive or continue receiving periodic email updates from Volunteers of America North Louisiana Yes, I would like to receive postal mail from Volunteers of America North Louisiana Keep me logged in. What's this? Remembers your login information for your convenience. Use only on trusted, private computers. Privacy Policy Question - Not Required - Race/Ethnicity: Please select response African American Caucasian Hispanic Native American Pacific Islander/Asian Other * Question - Required - How would you like us to contact you? Please select response Phone Call Email Either Question - Not Required - What is your current occupation? Question - Not Required - What is your educational background (high school, some college, degrees earned, etc.)? Question - Not Required - What are your hobbies, skills or interests? * Question - Required - Do you know how you would like to volunteer with us? For a list of volunteer opportunities, copy and paste this link into your browser: https://voanorthla.org/get-connected/#volunteer (Maximum response 255 chars, approx. 5 rows of text) Question - Not Required - Please check any of the populations with whom you are interested in working: Please make up to 5 selections from the choices below. Children ages K-8th Grade Teens Seniors Veterans Adults with Disabilities Question - Not Required - How often would you like to volunteer? Please select response Weekly Monthly Occasionally Other Question - Not Required - What times/days are you available to volunteer? Please make up to 5 selections from the choices below. Weekdays Weekends Mornings Afternoons Evenings Question - Not Required - If you have a disability, please list any accommodations you need to volunteer: (Maximum response 255 chars, approx. 5 rows of text) * Question - Required - Have you been convicted of a criminal offense? Please select response Yes No * Question - Required - Liability Release: I wish to volunteer. I may perform in a capacity as a volunteer that may involve physical activity, contact with unidentified and/or unfamiliar persons, or other potential risk of bodily injury or damage to property. Knowing this and in consideration of being allowed to volunteer, I HEREBY ASSUME FULL AND COMPLETE RESPONSIBILITY FOR ANY PERSONAL INJURY AND/OR PROPERTY DAMAGE THAT I SUSTAIN OR CAUSED DURING MY PARTICIPATION AS A VOLUNTEER. IN ADDITION, I HEREBY RELEASE, HOLD HARMLESS AND CONVENANT NOT TO FILE SUIT AGAINST ANY GROUP AFFILIATED WITH THIS VOLUNTEER OPPORTUNITY.* Please select response Agree Disagree * Question - Required - Policies and Procedures: I have read and understand the volunteer policies and procedures that are listed online at www.voanorthla.org under the volunteer tab. I understand that failure to adhere to these policies may result in termination of my volunteer placement with Volunteers of America of North Louisiana* Please select response Agree Disagree * Question - Required - Mandatory reporting: I understand that under Children's Code Article 609(A) I will be considered a "mandatory reporter," and will be obligated to report any abuse, neglect, or sexual misconduct of any client, staff, or volunteer of Volunteers of America.* If you believe any of this activity has occurred, please report the activity to the program supervisor immediately and complete an incident report for required documentation.* Please select response Agree Disagree * Question - Required - Photo Release: As a volunteer I hereby give my consent for representatives of this event, news media and others affiliated, to photograph me while volunteering. I also give my permission for the use of said photographs in literature, websites and other promotional materials.* Please select response Agree Disagree * Question - Required - SchoolMessenger Release: As a volunteer, I give Volunteers of America North Louisiana my consent to contact me via SchoolMessenger, a Short Message Service (SMS) used to more effectively communicate via phone, text, and e-mail.* Please select response Agree Disagree * Question - Required - Volunteers of America North Louisiana (VOANLA) has put in place preventative measures to reduce the spread of COVID-19; however, VOANLA cannot guarantee that you and/or your child will not become infected with COVID-19. Further, participation in activities associated with VOANLA could increase your or your child's risk of contracting COVID-19. I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to myself and/or to my child (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I may experience or incur in connection with my participation in volunteering with VOANLA. Please select response Agree Disagree * Question - Required - I verify that the above information is true. I understand that any false or misleading information is ground for denying or terminating my volunteer placement. I further understand that copies of this application will be sent to the Volunteers of America program in which I have indicated interest. The original will be retained in my volunteer personnel file. This understanding is certified by my signature below: Spam Control Text: Please leave this field empty