Volunteer Application

First Name *

Last Name *

Address *

City *

State *

Zip Code *

Phone - Preferred *

Phone - Other

Email Address *

Birth Month *

Birth Year *

Current Student?

Yes

Emergency Contact *

Relationship *

Phone Number *

Are there any skills at which you are proficient that you would be willing to share with the BOC if the opportunity arises?

Do you have any physical limitations?

Previous Work / Volunteer Experience

Position 1 *

Company/Agency 1 *

Position 2

Company/Agency 2

General Information

Do you attend a local church? *

Yes

If yes, which church? *

We receive support from some churches based on the number of members who volunteer at BOC.

How did you hear about us?

Background Information

Have you ever been convicted of a crime? You may omit minor traffic offenses, any convictions which have been sealed, expunged or statutorily eradication, and misdemeanors for which probation was complete and the case was judicially dismissed. *

Yes

If yes, please explain *

Do you have any outstanding court order community service hours? *

Yes

If yes, please explain *

ADVISORY: A check of the volunteer applicants criminal history may be made to verify the responses to the above question for the sole purpose of ensuring the safety of the staff, volunteers, clients, and visitors. No applicant will be denied volunteer status solely on the grounds of conviction of a crime. The nature of the offense, the date of the offense, the surrounding circumstances and the relevance of the offense to the position will be considered.

References

Reference Name *

Phone Number *

Relationship *

Reference Name *

Phone Number *

Relationship *

Bixby Outreach Center Policies

CHILD SAFE PLACE: Bixby Outreach Center strives to be worthy of a very high standard of trust. We desire to be a safe place for all youth and children, both volunteers and clients, and to reduce the possibility of child abuse of any form occurring at BOC. For this reason, every worker (staff or volunteer) who serves at BOC must avoid even the appearance of inappropriate behavior. All workers must diligently avoid any conduct that appears wrong to a reasonable observer, even if no actual misconduct takes place.

CONFIDENTIALITY: Volunteers and staff are required to keep all information that is obtained directly or indirectly concerning clients and donors absolutely confidential. This includes, but is not limited to, client list, client files, intake information, donor lists, and conversations concerning client data and donors.

DRESS CODE: Volunteers are asked to dress in a manner that is modest and appropriate for the position. Please refrain from wearing tank-tops, midriff tops, short shorts and any clothing that is: tight, low-cut, has lewd or indecent imprints on it.

A HIGH STANDARD: Bixby Outreach Center strives to maintain a respectful work environment free from harassment and other behaviors that might create an intimidating, hostile, or offensive environment. The center does not tolerate offensive language or behavior, alcohol or drug use, harassment or behavior demeaning to any group or individual. See Code of Conduct & Volunteer Rights and Responsibilities for more information.

Checkboxes *

"I certify that all information submitted by me on this application is true and complete. I understand that if any false information, omissions, or misrepresentations are discovered, my application may be rejected. In consideration of my volunteer application, I agree to adhere to the policies and regulations of Bixby Outreach Center, and I agree that my volunteer status can be terminated, with or without cause, at any time by the Bixby Outreach Center."

Availability

Interests

Previous Work / Volunteer Experience

General Information

Background Information

References

Bixby Outreach Center Policies