Volunteer ApplicationInstruction:Complete the application below and SubmitName* First Last Today's Date* MM slash DD slash YYYY Address* Street Address Address Line 2 City State ZIP / Postal Code Phone*Secondary PhoneEmail* I have been fully Covid-19 vaccinated Yes NoLanguages SpokenIn case of emergency, we have your permission to contact:Name First Last RelationshipPrimary PhoneSecondary PhoneEmail AvailabilityPlease check the days and times you may be able to volunteer. Most commitments are 2 hours or less.Available Times My schedule is flexible and I may be available any of these times Mornings between 6-12 Afternoons between 12-6 Evenings between 6-8My preferred days are Select All Mondays Tuesdays Wednesdays Thursdays Fridays Saturdays Sundays No preferred daysWould you prefer: A Regular Assignment An Occasional AssignmentVolunteer Opportunities at Neighbors Network (check all areas of interest): SOCIAL: includes friendly visits, reading, walking buddy, playing games, phone calls DRIVE/RUN ERRANDS: includes doctor visits, grocery shopping, drop off/pick up at hairdresser, gym, physical therapy, QUICK errands without Member accompanying you ORGANIZING: includes opening mail, organize closet, sort photos, filing, shredding, moving light furniture and boxes TECH SUPPORT: includes help with phones, computers, tablets, cable TV remotes, email HANDY PERSON: small repairs, set-ups, etc. HOUSEHOLD TASKS: includes both indoor and outdoor, meal prep, mending, organize kitchen, light dusting, pet care, tidy patio, pull weeds, rake leaves I’d like to gather a small gardening team from my neighborhood, club, faith community I’d like to discuss a regular assignment (like a weekly friendly visit or driving trip)Additional opportunities: Help with special events Become a NN Committee Member Office tasks for NN Be a part of Social/Educational programs offered by NNSpecial skills/hobbies you may be willing to share with members, i.e., knitting, stamp collecting, etc.:How did you hear about volunteer opportunities with Neighbors Network?Please Confirm* I am physically and mentally able to perform all the volunteer activities I have checked above.Personal ReferencesTWO required and please, no relatives. We kindly request that you notify your references in advance to inform them about Neighbors Network and your interest in volunteering.Reference #1Name First Last PhoneEmail Reference #2Name First Last PhoneEmail Neighbors Network Volunteer Agreement(Please read the following information carefully.)I agree to protect the confidentiality of all information pertaining to any Neighbors Network (NN) member, non-member or other volunteer associated with NN. My signature below acknowledges my agreement to adhere to this confidentiality policy.I understand that NN will review this information and all other information required to complete my application and that my application does not obligate NN to offer me a volunteer assignment. I hereby grant permission to any individual, school representative, company or corporation to give NN any relevant information that may be required to arrive at a decision on the status of this application. I release NN, its officers, employees, agents and representatives from any and all liability and /or damages incurred by me in accessing or using such information.If accepted as a volunteer for Neighbors Network, I understand that I am an important ambassador for Neighbors Network within the community, and I will not make statements representing the organization unless I have permission to do so. I also understand that I may not sign any agreement involving contractual or financial obligations. I also agree to abide by guidelines for volunteer behavior and language as described in the Neighbors Network Volunteer Handbook.I understand that a background check may be required, depending on the frequency and type of volunteering I may be performing; if required, I agree to participate in the organization’s background check process.I give my permission to be photographed and videotaped and for these images to be used by Neighbors Network in its marketing materials in print and electronic media at its sole discretion.Agreement: My signature acknowledges that I have read and agree to the information above and confirmed the accuracy of the information provided.Signed: (use mouse or fingertip to sign in this space)*Name* First Last Date* MM slash DD slash YYYY Thank you for applying to be a Neighbors Network Volunteer!ΔQuestions?E-mail: mary@neighborsnetworkfl.org