North Coast Community Homes · Volunteer Application

CONTACT INFORMATION

Name

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First Name

Last Name

Address

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Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Email

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Verify Email

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Phone

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Birthdate

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(mm/dd/yyyy)

Employment Status

Full-time

Part-time

Retired

Unemployed

Student

Other

Mailing List

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I want to stay in the know about North Coast Community Homes (NCCH), please add me to the mailing list. Note: North Coast Community Homes does not share or sell its mailing list.

Yes

No

VOLUNTEER INTERESTS

Volunteer Activity

What volunteer activities interest you?

In-house activities with NCCH Residents

Yardwork/Landscaping at NCCH Homes

Interior Painting at NCCH Homes

Furniture & Houseware Delivery

NCCH Boundless Journeys Resource Center

Community Events

Office Support

How Often

How often are you interested in volunteering?

Weekly

Monthly

As Needed

One-time

Volunteer Experience

What volunteer activities have you done in the past?

DISCLOSURES & BACKGROUND CHECKS

North Coast Community Homes conducts both initial and annual background screenings. A conviction does not necessarily disqualify an applicant. Failure to disclose may result in disqualification or termination.

Background Check Release

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I hereby authorize North Coast Community Homes or other authorized representatives of the Agency bearing this Release, or copy thereof, within one year of its date, to obtain any information in your files pertaining to any felony convictions through First Advantage National Criminal File, sexual offences through the National Sex Offender Registry (Dept. of Justice) and for Social Security Number Verification. I understand if any misdemeanors are listed that the North Coast Community Homes reserves the right to determine if I can continue as a volunteer. I hereby direct you to release such information upon request of the bearer. I hereby release you, as the custodian of such records, and any law enforcement agency, including its officers, employees, or related personnel, both individually and collectively, from any and all liability for damages of whatever kind which may at any time result to me, my heirs or associates, because of your compliance with this authorization and request to release information, or any attempt to comply with it or the nature of the information you provide. This Release is executed with the full knowledge and understanding that the information will be used in connection with the consideration of my volunteering by North Coast Community Homes. Should there be any question as to the validity of this Release, you may contact the Agency as indicated above.

Yes

No

Social Media Policy

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I understand volunteers are prohibited from being “Friends” on Facebook, or “Followers” on Twitter, or engaging in any other kind of personal relationship via social media outlets with NCCH residents. I will follow North Coast Community Homes' social media policy, including ensuring the privacy of residents and program participants.

Yes

No

Statement of Applicant

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By submitting this application, I affirm that the facts set forth in it are true and complete. I understand that if I'm accepted as a volunteer, any false statements, omissions, or other misrepresentations may result in my immediate dismissal. I understand that my current employer, the volunteer site that I have listed in my application and law enforcement/criminal records agencies may be contacted by North Coast Community Homes on my behalf.

Yes

No

Typed Volunteer Name for Consent

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