VOLUNTEER PROFILE. Name: (First) (Last) Address: City: State: Zip: Preferred Contact (please check one): Phone: (Home) (Cell) _.

Transcription

1 Date: VOLUNTEER PROFILE Name: (First) (Last) Address: City: State: Zip: Birthday: Preferred Contact (please check one): Phone: (Home) (Cell) _ Emergency Contact Name: Phone: Relationship to volunteer: Driving Information (Required if your choice of volunteer responsibilities includes driving): Driver s License #: Issuing State: Expiration Date: Auto Insurance: Employment Information: Occupation: Employer: City: State: Zip: _ Education Information: Highest Level of Education Completed: Major/Degree: Are you a student now? Yes No Are you multilingual? Yes No If yes, in what languages? Community Service: Is this a community service requirement? Yes No If yes, is it: court-ordered school Number of hours needed: School or program name: Date due by:

2 Court Ordered Service: - Individuals with court mandated community service hours are accepted by PAWS San Diego. However, we ONLY accept misdemeanor offenses, excluding violent crimes of any nature. You must provide valid and updated documentation. - Conviction cannot be related to animal abuse, or any misconduct associated with elderly, disabled, or chronically ill persons. - As a court ordered volunteer you agree to at least 20 hours of volunteer service, otherwise paperwork will not be signed by PAWS. Have you ever been arrested? Yes No Have you ever been convicted of a crime? Yes No If yes, please explain: Do you have any physical limitations or disabilities? Yes If yes, please explain: No PAWS does not discriminate on the basis of race, ethnicity, religious affiliation, age, sex, disabilities, or sexual orientation. Volunteer Experience Please share your current and previous experience volunteering:

3 INTEREST/AVAILABILITY Availability: Weekday Mornings Weekday Afternoons Weekday Evenings Weekend Days Weekend Evenings Other Specific days and times: Areas of Interest: OFFICE: COMMITTEE: Front Office Phones Database Input Fundraising Operations Annual Fiesta Fundraiser Marketing/PR/Communications WAREHOUSE: Food Pull Inventory DRIVERS: Food Deliveries/Driver Client Transportation Food Pick up PAWS Pantry General Warehouse Support SPECIFIC SKILLS: OTHER: Graphic Design Website Outreach Events Dog Walking Photography Other Why do you want to volunteer with PAWS? (Please check all that apply) Make new friends Job experience Career change Love of animals Looking to give back Want to fill time Personal reasons Other How did you hear about PAWS? Special Event Internet/Website TV/Radio Veterinarian Community Referral Current Donor Newspaper/Magazine Current Client Friend/Client (name) Other

4 PAWS San Diego Confidentiality Hold Harmless Agreement Terms and Agreements Please read carefully Media Release: I give permission to PAWS to use photographs, and/or video, and/or audio of me obtained while participating as a volunteer with the Agency. I release the Agency from any and all liabilities arising from the use of these items for publicity purposes and waive the right to all negatives, photos, tapes and reproduction, as well as waive my right to inspect or approve the finished photographs and/or tapes. Confidentiality Clause: PAWS is a social service agency where a high level of confidentiality is maintained at all times. Volunteers are agents of PAWS and must abide by the same confidential standards as the staff. Confidential information includes: The fact that a person is or has been a client; any information given in confidence; any information about the client, such as his/her identity, problem, or treatment. PAWS volunteers agree to the following: Volunteer should share information about a PAWS client only with the volunteer s supervisor, worker or caseworker s supervisor, or appropriate PAWS staff member, volunteers will not communicate confidential information to anyone outside of the agency. The use of a case record for training purposes is not a breach of confidentiality. Speaking of your volunteer assignment in general terms, avoiding use of any client names, is not a breach of confidentiality. Liability Waiver: In consideration of my voluntary participation in a PAWS program, I hereby agree to the following I hereby release, waive, indemnify and hold harmless PAWS, its directors, officers, employees and volunteers from any loss, liability, and damage due to my voluntary participation in a PAWS program. I hereby assume full responsibility for the risk of bodily injury, death or property damage. I further agree that the foregoing release and waiver of liability and indemnity agreement is intended to be as broad and inclusive as is permitted by the law of the state of California, and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. Depending on the volunteer position, you may be asked to provide a copy of your current proof of vehicle insurance. All volunteers participating in programs involving driving on behalf of the agency must carry personal vehicle insurance required by California law. I certify that all information given on this volunteer application for PAWS is true, complete and correct. I authorize PAWS to contact the references provided and continue with background checks as needed. I understand that any false information on this application is cause for termination as a volunteer for PAWS. I also understand that any behavior deemed intolerable, rude, or unjustified is also cause for termination. I Agree Release of Liability for Minors: I, the undersigned parent or guardian of a minor participating with or without me, attests that I am over 18 years of age and warrant that I have legal authority to execute the above agreement on my child or legal ward s behalf. I have read, acknowledged and understand all agreements, statements and requirements of this document. I HAVE READ AND UNDERSTAND THE CONFIDENTIALITY AGREEMENT, HAVE HAD MY QUESTIONS FULLY ADDRESSED, AND HAVE RECEIVED A COPY FOR MY PERMANENT PERSONAL RECORDS. Print Name of Parent or Guardian Signature of Parent or Guardian Date Relationship to minor

5 ELDER ABUSE REPORTING Elder abuse is a term that refers to any knowing, intentional, or negligent act by a caretaker or any other person that causes harm, or a serious risk of harm, to a vulnerable adult. In California, anyone age 65 or older is protected by a special set of laws called The Elder Adult and Dependent Adult Civil Protection Act ("The Elder Abuse Act"), which is a powerful set of laws designed to help prevent neglect and abuse to California seniors. (Welf & I C et seq.) Under The Elder Abuse Act, "abuse" is defined broadly and includes any physical abuse, neglect, financial abuse, abandonment, isolation, abduction, or other treatment resulting in physical harm or pain or mental suffering. Broadly defined, abuse to an older person or senior citizen may be: Physical Abuse - Inflicting, or threatening to inflict, physical pain or injury on a vulnerable elder, or depriving them of a basic need. Emotional Abuse - Inflicting mental pain, anguish, or distress on an elder person through verbal or nonverbal acts. Sexual Abuse - Non-consensual sexual contact of any kind. Exploitation - Illegal taking, misuse, or concealment of funds, property, or assets of a vulnerable elder. Neglect - Refusal or failure by those responsible to provide food, shelter, health care or protection for a vulnerable elder. Abandonment - The desertion of a vulnerable elder by anyone who has assumed the responsibility for care or custody of that person. As used in this section, "caretaker" means any person who has the care, custody, or control of or who stands in a position of trust with an elder or a dependent adult. I hereby acknowledge that I understand my obligations as a mandated reporter of suspected elder abuse and agree to fulfill my responsibilities as described above. Signature Date I hereby acknowledge that I have reviewed the elder abuse reporting, mandates and current agency policies with the above volunteer. Signature (Volunteer Coordinator) Date

6 VOLUNTEER JOB DESCRIPTIONS San Diego Office Support The PAWS office is volunteer run and relies on volunteers for general clerical assistance during normal business hours (M-F 10am-2pm). Volunteers handle all incoming telephone interactions, which include answering the telephone, client problem resolution, animal welfare referrals and providing general information about PAWS and its services. You must be customer service oriented and have good communication skills with an emphasis on problem solving. It also includes but is not limited to important activities such as general office maintenance, file maintenance and the preparation of client information packages. Outreach Events PAWS attends events throughout the year providing information about the organization to the community. This opportunity includes event set up and tear down and educating the general public about PAWS in a positive and energetic way. Food Pick-Up/Inventory PAWS often receives contributions of food and litter which need to be retrieved and taken to the PAWS warehouse in either Encinitas or San Diego. PAWS receives both scheduled and impromptu donations and needs volunteers that can commit to a specific re-occurring pick-up as well as as-needed pick-ups. You should have an appropriate vehicle for carrying donated food, current California License and current liability insurance to participate. Food Warehouse Support Many of the warehouse activities include re-stocking the shelves with food and litter, pulling food for client deliveries or pick-ups, or dividing big bags of food into smaller bags. Warehouse volunteers may be called upon to help as a team or individually. Warehouse activities can be very physical in nature so the ability to lift 40lbs. is a must! Food Delivery Driver PAWS provides almost 300 clients pet food delivery once a month. In North County, food deliveries begin the third Friday of each month and in the greater San Diego metro area deliveries occur the fourth Saturday of each month. You must have a healthy back and be capable of lifting 40lbs. In addition, you must have a valid California Driver s License, current liability insurance, and a vehicle capable of carrying food for delivery. This is a great activity for families looking to include younger children in a volunteer activity! Companion Animal Transportation PAWS provides companion animal transportation for the companion animals of our clients to and from veterinarian appointments. You should have a vehicle appropriate to transport a client and their companion animal, a valid California Driver s License and current liability insurance. Also you should have the time available to make a roundtrip with the client (normally around 2 hours). Dog Walking For those PAWS clients who are medically distressed or disabled, volunteers provide services such as dog walking and inhome care (ensuring the companion animals have food and clean water, and clean litter). It is a great opportunity for those who desire a closer and more personal client and companion animal connection and experience. You must be able to commit to a six-month timeframe and a consistent visitation schedule.

7 Fiesta- Annual Fundraising Event PAWS s major fundraising event is the Fiesta held in June. Volunteer activities for Fiesta del PAWS includes assistance with the pre-event mailings of printed materials, assistance with event planning, event set-up, cashiering, catering assistance, bartending, security assistance, public relations, marketing, and more! Board and Advisory Committee If you or someone you know is interested in learning more about PAWS Board and Advisory Committee positions, please contact PAWS at (619) for additional information. Pet Food Drives Increase your impact in the PAWS community by hosting a pet food drive at your work or school to increase knowledge of PAWS and help feed more companion animals! Contact the office for more information. PAWS Pantry Sign up a group to help split large bags of cat and dog food into smaller emergency rations! PAWS works with local senior centers and food distribution sites to provide emergency pet food to low-income San Diego residents that are not PAWS clients. This is a great project for businesses or groups looking to get more involved in the community or youth groups looking to fulfill service hours. Contact the PAWS Volunteer Coordinator for more information. Please contact PAWS San Diego with any questions or to speak with the Volunteer Coordinator at (619) or by at outreach@pawssandiego.org.