Camp Erin 2009 - New Volunteer Application

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1. Basic Information

Basic Information Name:
Address:
Address 2:
City/Town:
State:
ZIP/Postal Code:
Email Address:
Phone Number:

2. Date of Birth (optional)

	MM		DD		YYYY
MM/DD/YYYY	Date of Birth (optional) MM/DD/YYYY Month	/	Day	/	Year

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3. How did you hear about Camp Erin?

How did you hear about Camp Erin?

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4. Why do you want to volunteer for Camp Erin?

Why do you want to volunteer for Camp Erin?

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5. Do you have any personal or work experience with the following?

Do you have any personal or work experience with the following? Children

Camp

Terminal Illness

Death of a Loved One

Bereavement Work

If yes, please explain circumstances briefly here and give the date(s)

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6. Please use the space below to describe relevant volunteer experience, special training, hobbies, interests or experiences that you feel could be valuable to your volunteer service (such as educational background, office skills, arts & crafts, games, writing, speaking, teaching, music, education, community or civic activities, personal goals, etc.).

Please use the space below to describe relevant volunteer experience, special training, hobbies, interests or experiences that you feel could be valuable to your volunteer service (such as educational background, office skills, arts & crafts, games, writing, speaking, teaching, music, education, community or civic activities, personal goals, etc.).

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7. What is your interest? (Check all that apply) Training is mandatory and will be provided.

What is your interest? (Check all that apply) Training is mandatory and will be provided. Big Buddy

Lead Big Buddy

Float Big Buddy

Clinical Lead

Registration Committee

Welcoming Committee

Arts/Crafts Committee (pre-camp)

Entertainment Committee

Games Committee

Snack Committee

Pre-Camp Meal Committee

Logistics Committee

Ritual Committee

Rainy Day/Back up Plan Committee

Fundraising/Donation Committee

Music Director

Camp Photographer

Camp Nurse

Music Therapy Workshop Facilitator

Art Therapy Workshop Facilitator

Movement Therapy Workshop Facilitator

Knitting Teddy Bear sweaters

Making camper quilts

Help with Camper & Family Information night

If you have another idea, please let us know...

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8. There are several training and social events (the required events are noted below) through out the year. Please check those that you know you will be able to attend.

There are several training and social events (the required events are noted below) through out the year. Please check those that you know you will be able to attend. Kick off (Thursday, April 23rd)

New Volunteer Training (Wednesday, May 6th) - Required

All Staff Training (Saturday, July 11th) - Required

2nd Annual Shriky Dink Party (Thursday, July 20th)

Schedule Meeting (Tuesday, August 18th) - Required

Pizza Party (Thursday, August 20th) - Required

Camp Erin (August 28th-30th) - Required

Volunteer Appreciation (Thursday, September 17th)

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9. REFERENCES: Supply three personal or professional references with phone numbers and complete addresses.

REFERENCES: Supply three personal or professional references with phone numbers and complete addresses. Reference 1
Reference 2
Reference 3

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10. Providence Hospice Programs of Portland complies with Title VI of the Civil Rights Act. The Age Discrimination Act of 1975 as amended, and Section 504 of the Rehabilitation Act. Providence Hospice Programs of Portland does not discriminate with regard to race, color, religion, creed, national origin, age, sex, marital status or the presence of any sensory, mental or physical handicap, or ability to pay.

Please read carefully before signing and submitting your application.

I certify that the information supplied is true and complete to the best of my knowledge. I authorize all persons and institutions referred to in this application to provide Providence Health System with any information that it requests in connection with this application. I hereby release all of these persons and institutions and Providence Health System from any and all claims, liabilities, and damages for whatever reason arising from the verification process.

I understand that further steps in the application process may include checking of references, background checks, passing a drug screen and satisfactorily completing a health evaluation required by this agency. I am willing to attend Camp Erin volunteer training. I understand that if I become a Camp Erin Volunteer, I agree to adhere to the standards of conduct/performance and the personnel policies of Providence Hospice.

Providence Hospice Programs of Portland complies with Title VI of the Civil Rights Act. The Age Discrimination Act of 1975 as amended, and Section 504 of the Rehabilitation Act. Providence Hospice Programs of Portland does not discriminate with regard to race, color, religion, creed, national origin, age, sex, marital status or the presence of any sensory, mental or physical handicap, or ability to pay. Please read carefully before signing and submitting your application. I certify that the information supplied is true and complete to the best of my knowledge. I authorize all persons and institutions referred to in this application to provide Providence Health System with any information that it requests in connection with this application. I hereby release all of these persons and institutions and Providence Health System from any and all claims, liabilities, and damages for whatever reason arising from the verification process. I understand that further steps in the application process may include checking of references, background checks, passing a drug screen and satisfactorily completing a health evaluation required by this agency. I am willing to attend Camp Erin volunteer training. I understand that if I become a Camp Erin Volunteer, I agree to adhere to the standards of conduct/performance and the personnel policies of Providence Hospice. I agree

I disagree

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