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Individual Volunteer Application
Volunteers of America Southeast Louisiana (VOASELA) encourages the participation of volunteers who support our mission.  If you agree with our mission and are willing to participate  in available volunteer opportunities, we encourage you to complete this application.  The information on this form will be kept confidential and will help us find the most satisfying and appropriate volunteer opportunity for you. For more information regarding our volunteer program, please reach out to Michelle Hebert, Resource Development Managerr at mhebert@voasela.org or (504) 486-8697.
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Email *
Salutation *
First Name *
Last Name *
Email Address *
Street 1 *
Street 2
City
State
Zip Code *
Phone Number *
Date of Birth *
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I would like to receive regular email alerts from Volunteers of America Southeast Louisiana! *
What is your preferred method of contact (check all that apply) *
Required
Emergency Contact Name *
Emergency Contact Phone Number *
Emergency Contact Relation
Which areas are you interested in volunteering? (Please select all that apply)
Please indicate days that you are available to volunteer. ( check all that apply)
Please select timeframe that you are available.
Confidentiality Agreement
 The protection of information is vital to the interest of Volunteers of America Southeast Louisiana (VOASELA).  I understand that in the course of my volunteer experience with VOASELA, I may have access to and become acquainted with information of confidential, propriety or private nature that is or may be applicable or related to the present or future business of VOASELA, its research and development, or the business of its customers.  Such information includes, but is not limited to, the following: information about clients, former clients, or persons seeking services, including names, personal information, or other program information; financial information, vendor or donor information, contribution lists, and other information; and marketing strategies and data, new material research, pending projects and proposals, research and development strategies, materials, products, designs, plans, ideas, and data of the organization.
Selecting this box indicates that I agree not to disclose any of the above-mentioned information or other organizational information directly or indirectly and agree not to violate the spirit or intent of this provision. *
Required
Release of Liability
I, and my heirs, in consideration of my volunteering, hereby release Volunteers of America Southeast Louisiana (VOASELA) and their national affiliate Volunteers of America, its officers, employees, and agents, and any other people officially connected with this organization, from any and all liability for damage to or loss of personal property, sickness or physical injury from whatever source, legal entanglements, imprisonment, death, or loss of money, which might occur while participating in this event.  I understand that participation in this program is strictly voluntary, and I freely chose to participate.
By selecting here, I agree to the Release of Liability and I understand that I will be volunteering at my own risk. *
Required
Release and Waiver of Photography or Film
I hereby grant and convey unto Volunteers of America Southeast Louisiana (VOASELA) all right, title, and interest in any and all photographic images and video or audio recordings made by VOASELA during volunteer activities with VOASELA, including, but not limited to, any royalties, proceeds, or other benefits derived from such photographs or recordings.  I hereby release and waive any claims against VOASELA, its officers, directors, and employees, arising out of the publicity agreed to herein, including but not limited to matters arising under HIPAA and Medicaid waiver status.
Selecting this box indicates that I agree to release and waive all right, title, and interest in any and all photographic images and video or audio recordings made by VOASELA. *
Demographics Data
Volunteers of America Southeast Louisiana is a CARF accredited organization.  Per our accreditation, we are obligated to report on the demographics of volunteers we work with internally and refer to other organizations.
Ethnicity
Age
Parish/State
A copy of your responses will be emailed to the address you provided.
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