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HERO airs haiti411.org which serves as a reference for humanitarians and organizations to connect and save young lives in Haiti .
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Written by Administrator   
Monday, 25 May 2009 09:02
If you desire to become a volunteer with HERO. Please print this form, fill, email to This e-mail address is being protected from spambots. You need JavaScript enabled to view it or mail to: P. O. Box 5634, Huntsville, AL 35814

Volunteer Agreement

I understand that:

• The references I listed may be contacted by telephone or email.

• This application in no way obligates me to perform any volunteer service.

• I understand that my help is free and without expectation..

• All records and information gathered are the property of HERO.

• I hereby authorize HERO to conduct whatever investigation it may deem necessary to determine whether I can become an effective volunteer. I do herein affirm under oath and subject to penalties of perjury that the foregoing answers and statements are, to the best of my knowledge, true, correct, and complete.

• I understand that HERO uses photos of volunteers in a variety of activities for recruiting and promotional reasons. I am willing to support their efforts. HERO has my permission to use my name and photographs of me to promote the Organization's program.

• I understand that I must carry my own health insurance. I will not hold HERO responsible for any unforeseen injuries or problems that may occur on the job.


Name:

Date:

Address:

Home phone: Business:

Cell: Fax:

e-mail: male female

Birthday:

School/ Employer:

Year at School:

emergency contact:

emergency phone number:

Current employer and phone number

How did you hear about volunteering at HERO?

What hours and days would you be available?

Would you be interested in working with:

Technology (social networking, teaching computer classes, troubleshooting computers)

Administrative (filing, data entry, answering the phone, etc.) or in one of these committees:

1. Logistics Committee

2. Children’s Committee

3. Food Committee

4. Medical Committee

5. Music Committee

6. Fundraising Committee

What skills, hobbies, or interests would you like to contribute? What languages do you speak?

Do you get around by car or public transportation? Circle one.

Education

Please list any degrees or certifications and the school you attained them from.

Please list any previous volunteer experience:

Organization Title Key responsibilities

Have you ever been incarcerated?

Are you currently under a charge or have ever been convicted of or pled guilty to child abuse or a crime involving actual or attempted sexual misconduct or sexual molestation of a minor?

Yes _____ No _____ If yes, please explain: ___________________________

Please provide references whom we can contact:

Name Phone Occupation

If you regularly attend a church:

Church name

Pastor

Address

Telephone

Please sign or write name:______________________________________________

Last Updated on Monday, 18 January 2010 04:13
 
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