Engaging Families. Meeting Needs. Giving Hope. Thank you for inquiring about volunteering. Because we have many volunteers who can commit to regular days and hours, we are unable to accommodate individuals needing court-ordered community service hours. PERSONAL INFORMATIONName First Last Date MM slash DD slash YYYY Address Street Address City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Date of Birth(month and date only) MM slash DD slash YYYY Best phone number to reach you:Email Address EMERGENCY CONTACT INFORMATIONNameRelationship to youPhone Number:How did you hear about us?Why are you interested in volunteering with Solanco Neighborhood Ministries?What days and hours are you available to volunteer? Please be specific.Tell us about you. What previous work or volunteer experience have you had? What special skills/certifications do you have?How would you like to volunteer? Please check all that apply ❑ Office ❑ Packing food orders ❑ Working in warehouse ❑ Special events ❑ Church Liaison ❑ Fundraising Champion ❑ Transportation Do you have any physical limitations?YesNoIf yes, please list any ways we can accommodate you (allergies, physical restrictions, etc.):For your safety and the safety of other volunteers, we are unable to accept volunteers who have been convicted (found guilty) of a violent crime or theft. ❑ Have you ever been convicted of a violent crime or theft?YesNo❑ Do you have any criminal charges pending?YesNoI certify all information is true and has been given voluntarily. I understand that this information may be disclosed to any party with legal and proper interest. I release the agency from any liability whatsoever for supplying such informationSignatureDate MM slash DD slash YYYY CONFIDENTIALITY AND PHOTO RELEASEI consent to be photographed or videotaped and agree to allow Solanco Neighborhood Ministries to use any photo or video to be used for future promotional purposes. I understand that I will receive no remuneration in the event that any photographs, images, actions, or voice are used in ministry brochures, advertisements, or visual presentations Yes As a volunteer at Solanco Neighborhood Ministries, I understand that I may see, hear, and have access to confidential or sensitive facts, matters, documents, files, or other materials pertaining to S.N.M. clients. I will not discuss or disclose any of the above to anyone outside of the organization. I agree that the requirements of confidentiality extend from my time of volunteer service indefinitely into the future so long as the facts, matters, documents, files, or other materials are confidential or sensitive Yes SignatureDate MM slash DD slash YYYY
