Forms Center

Volunteer Application

2. Date Received
   Date Received

4. 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.

6. First Name

7. Last Name

9. Middle Name

11. Address

13. City

14. State

15. Zip Code

17. Home Phone Number

18. Message Number

20. Work Phone Number

21. Email Address

23. Are you over the age of 18?

    1. Yes
    2. No

24. 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

26. Do you have, or can you obtain, a valid Washington State Driver’s License?

    1. Yes
    2. No

27. Availability

    1. Long-term
    2. Short-term
    3. Special Project

29. Check the days you can be available for volunteer work

    1. Sunday
    2. Monday
    3. Tuesday
    4. Wednesday
    5. Thursday
    6. Friday
    7. Saturday

31. Are you currently certified in CPR?

    1. Yes
    2. No

32. Are you currently certified in First Aid?

    1. Yes
    2. No

34. In what particular areas of volunteer work are you interested?

36. What general skills/experience/education would you like to share in your volunteer work?

38. Criminal Convictions

40. 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?

    1. Yes
    2. No

42. If yes, please explain

44. Do you have any medical conditions physical or emotional that should be taken into consideration in arranging volunteer assignments?

    1. Yes
    2. No

46. If yes, please explain

48. In case of emergency please contact

49. Phone number of emergency contact

51. References
    Do not list relatives

    Do not list relatives

53. First Name

54. Last Name

56. Address

58. City

59. State

60. Zip Code

62. Phone Number

66. First Name

67. Last Name

69. Address

71. City

72. State

73. Zip Code

75. Phone Number

79. First Name

80. Last Name

82. Address

84. City

85. State

86. Zip Code

88. Phone Number

90. 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.

    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.

92. 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.<br><br>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.<br><br>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.

    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.

94. E-Signature

95. Date
    Date

97. If Under 18 Parent or Guardian’s E-Signature

98. Date
    Date

Leave This Blank:


100. 1. Receive an email copy of this form.
101. Email address

     This field is not part of the form submission.

102. Submit

* indicates a required field