Volunteer – REACH Inc.

Volunteer App

Step 1 of 2

Name*
First Middle Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Home Phone/Cell*
Work Phone
Area of Interest
Which Department are you interested in?*
Why Do You Want To Volunteer at REACH?*
Is there a person at REACH that you consider to be a personal contact?*
- Yes
- No
What is the contacts name?*
First Last
Contacts Phone Number*
Have you ever worked as a volunteer before?*
- Yes
- No
List where you previously volunteered at*
Organization Name Years volunteered Address Phone # Supervisor Name

References
Please provide the following information for three people or more who are over 18 years of age, not related to you and are able to provide a reference supporting your integrity, Character, and personal commitment.
*
Name Years known Address Phone # Relationship
Have you ever been convicted of a crime other than a minor traffic violation?*
- Yes
- No
Please Explain (nature of crime, date, sentence, Rehabilitation)*
Do you have any criminal charges pending against you?*
- Yes
- No
Please Explain (nature of crime, date, sentence, Rehabilitation)*
PLEASE READ
Consent*
REACH Inc. is a 501(c3) nonprofit agency that does contract services for the Oregon Department of Human Services and therefore is responsible to live up to Oregon Regulations governing the handling of affairs for people who are considered Vulnerable Populations. REACH Inc. takes that responsibility very seriously and would like you to know that if you are selected to be a volunteer at REACH you will be required to live up to these requirements as well.

Some of these things are:

1. You Will Be Required To Pass a Background Check a minimum of every 2 years.

2. You will be Required To Pass a Pre Employment Drug and Alcohol Screening (Including Marijuana)

3. You, Will, be Required to Pass any Random Drug and Alcohol testing asked of you by REACH Inc.

The information contained in this application is correct to the best of my knowledge. I authorize any references listed on the application to give any information (including opinions) that they may be regarding my character and fitness for work with REACH participants. I release all such references from any liability for furnishing such evaluations to you, providing they do so in good faith and without malice.

I understand this is not an application for employment.

I further understand the REACH Inc. takes abuse very seriously and abuse in any form will not be tolerated. I am aware that my participation in abuse in any form is cause for removal from volunteer Services.
I agree
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Comments
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Organization Name	Years volunteered	Address	Phone #	Supervisor Name

Volunteer App

Step 1 of 2

Area of Interest

References

PLEASE READ

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