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Volunteer Application
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The City of Snoqualmie operates a volunteer program that provides services organization-wide. The purpose of the program is to enable the City to take advantage of the extraordinary reserve of knowledge, talent, and skill possessed by volunteers within our community and to capitalize on these abilities to augment City services. The intent is also to provide a program which involves interested residents in local government while providing them the opportunity to perform work of value to the community.
The volunteer application is designed to give applicants an opportunity to share their background, experience, interests and skills, enabling the City to make the best possible volunteer placement.
First Name
Last Name
Middle Name
Address
City
State
Zip Code
Home Phone Number
Message Number
Work Phone Number
Email Address
Are you over the age of 18?
Yes
No
If you are not over the age of 18, provide date of birth
If you are not over the age of 18, provide date of birth
Do you have, or can you obtain, a valid Washington State Driver’s License?
Yes
No
Availability
Long-term
Short-term
Special Project
Check the days you can be available for volunteer work
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Are you currently certified in CPR?
Yes
No
Are you currently certified in First Aid?
Yes
No
In what particular areas of volunteer work are you interested?
What general skills/experience/education would you like to share in your volunteer work?
Criminal Convictions
Have you been convicted of a felony or released from prison within the last ten 10, or have been convicted of a misdemeanor other than minor traffic offenses within the past 3 years?
Yes
No
If yes, please explain
Do you have any medical conditions physical or emotional that should be taken into consideration in arranging volunteer assignments?
Yes
No
If yes, please explain
In case of emergency please contact
Phone number of emergency contact
References
Do not list relatives
First Name
Last Name
Address
City
State
Zip Code
Phone Number
First Name
Last Name
Address
City
State
Zip Code
Phone Number
First Name
Last Name
Address
City
State
Zip Code
Phone Number
Notice to Volunteers
Volunteers are not considered to be City of Snoqualmie employees. Injury Compensation is provided through the Department of Labor and Industries. Volunteer service is considered to be creditable work experience. The data furnished on this form is furnished voluntarily and will be used to contact, interview and place volunteers.
Signature is Required
To the best of my knowledge, the information herein is true and complete. I understand that falsification of this application is grounds for dismissal as a volunteer. Further I give permission for an authorized representative of the City to conduct a state patrol criminal background check in accordance with RCW 43.43.830-839 and to inquire of individuals about my ability to perform all aspects of the volunteer position for which I am being considered and I release the City of Snoqualmie and those individuals/institutions that provide information from any liability that may arise from the provision of this information.
As a volunteer for the City of Snoqualmie, I am fully aware that the work associated with being a City Volunteer involves certain risks of physical injury or death. Being fully informed as to these risks and in consideration of my being allowed to participate in the City’s Volunteer Program, I hereby assume all risk of injury, damage and harm to myself arising from such activities or use of City facilities. I also hereby individually and on behalf of my heirs, executors and assignees, release and hold harmless the City of Snoqualmie, its officials, employees and agents and waive any right of recovery that I might have to bring a claim or a lawsuit against them for any personal injury, death or other consequences occurring to me arising out of my volunteer activities.
I give permission to have my photo taken and used for publicity purposes by the City. I authorize any necessary emergency medical treatment that might be required for me in the event of physical injury and/or accident to me while participating in this program.
E-Signature
Date
Date
If Under 18 Parent or Guardian’s E-Signature
Date
Date
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