Volunteer Application

Volunteer Type

Please specify why you are volunteering

Desired Volunteer Program

First Name

* Required

Last Name

* Required

Company

If you are with an organization, please note it here.

Other Names or Nickname

Home Address

* Required

City

* Required

State

* Required

Zip

* Required

Primary Phone

* Required

Home Phone

Work Phone

Email

* Required

Volunteer Employer

Emergency Contact Name

Emergency Contact Address

Emergency Contact Phone

Do you have any medical of physical limitations?

If Yes to Physical Limitations, please specify

Password

* Required

Please enter a password, this will be used
when you login to view volunteer opportunities.

The following information is used only for reporting aggregate numbers to our funders

For reporting purposes, your date of birth is important to us. Please enter as mm/dd/yyyy. Day field may be listed as '01'.

Birthday

* Required

Race

Gender

Are you a Veteran

VOLUNTEER AGREEMENT

Agreement to adhere to coronavirus precautionary measures:

I acknowledge that New Bethany Ministries is doing everything it can to protect the public as well as its staff and volunteers. To this extent, I agree to follow Center of Disease Control (CDC) and local health district guidelines and New Bethany Ministries policies and procedures for social distancing to reduce the spread of Novel Coronavirus, or COVID-19 or any other communicable disease. This will require me to maintain six (6) feet of distance between myself, staff, and other patrons of the organization as much as humanly possible. I agree to properly wear a face covering or improvised mask such as a scarf, bandana, and/or handkerchief over my nose and mouth to reduce the risk of exposure to myself and others.

Agreement to keep New Bethany client data confidential:

I understand that in the course of my volunteer work I may learn the identity and other information concerning clients of NBM. I agree not to disclose their names or any other information concerning clients of NBM, to anyone except authorized NBM staff or volunteers, and solely for the purpose of providing NBM services or conducting NBM projects in the program area to which I am assigned.

Hold harmless agreement:

I agree not to hold NBM, its officers, staff, volunteers, or clients liable for any injury or illness in the very unlikely event that this may result from my volunteer service to program clients.

Permission to use photographs and/or audio-visual:

I give permission to New Bethany Ministries to use, reproduce, publish photographs and/or video. I understand that this material may be used in various publications, press releases, fundraising materials, televised broadcasts, or on the New Bethany website and social media pages.

Please affirm the following, as required by the Child Protective Service Law

By signing this agreement, I affirm that I have not been named as a perpetrator of a founded report of child abuse within the past five (5) years as defined by the Child Protective Services Law.

Volunteer Opportunity Agreement

* Required

Please note any exceptions to this agreement here.

Volunteer Exceptions

Please leave this checkbox blank

VOLUNTEER AGREEMENT