Slate Valley Cares - Volunteer Application Form
Thanks for your interest in volunteering with Slate Valley Cares (formerly Fair Haven Concerned), in Fair Haven, VT. 

About this form:
Volunteers play a vital role in our community. All volunteer applications are reviewed with consideration of current volunteer opportunities.

Next steps:
After you submit the form, we will review your application and contact you if we have any open positions that seem like a good fit. We may contact you to schedule a quick volunteer orientation, which should take about 30 mins to an hour, depending on how many questions you might have. 

Please be patient with us while we review your application. Feel free to call us at 802-265-3666 if you are interested in a follow up or status update. Thank you for your support of Slate Valley Cares! 
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Email *
First Name *
Last Name *
Phone Number
Street Address
City of Residence *
State
Zip Code
Your Birthdate
MM
/
DD
/
YYYY
In case of emergency, who should we contact? Please list their full name. *
What is the phone number of your emergency contact? *
Do you have particular skills, interests, or qualities that you'd like to use in your voluntary work?  *
What kind of volunteer work interests you? *
Required
When are you available to volunteer? 
Mornings
Afternoons
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday/Sunday (occasional events)
I'm totally flexible!
Is there any additional information you'd like to bring to our attention?
Equal Opportunity Statement
Slate Valley Cares (formerly Fair Haven Concerned) is committed to equal opportunities and all volunteer recruitment decisions will be based on merit, suitability for the role and experience. All volunteer recruitment decisions will not be influenced by race, color, nationality, religion, sex, marital status, family status, sexual orientation, disability or age. Slate Valley Cares fully endorses a work environment free from discrimination and harassment. 

Your volunteer role may have direct contact with children. Please answer the question below.
Have you ever been convicted of an offense in the State of Vermont or elsewhere?  *
If yes, please provide details below.
Confidentiality Agreement
Slate Valley Cares (formerly Fair Haven Concerned Inc.) is committed to safeguarding the privacy of its clients and maintains that all information, whether written, electronic, overheard, observed, or verbal must be kept confidential. Board of Directors, employees, subcontractors, and volunteers are to maintain all information regarding the visitation of clients for assistance of any kind as confidential. 

Failure to maintain confidentiality may result in an individual's inability to continue serving the Slate Valley Cares organization.
Do you agree with the Confidentiality Agreement? *
Required
Volunteer Agreement
I volunteer my services with Slate Valley Cares (formerly Fair Haven Concerned Inc.) and understand that I am not considered an employee of Slate Valley Cares or partner organizations. I understand that I will not be paid for my services and that I may stop volunteering at any time I wish. I agree that Slate Valley Cares may utilize a photo(s) of me taken while serving as a volunteer for public awareness or educational purposes.
Do you agree with the Volunteer Agreement? *
Required
Automobile Insurance Statement
I understand that if I use my personal automobile in volunteering my services with Slate Valley Cares, I will arrange to keep in effect my own automobile insurance equal to the minimum amount required by the State of Vermont. I also agree to keep my drivers license current. 

Do you agree with the Automobile Insurance Statement? *
Required
Release of Liability
I hereby certify that Slate Valley Cares (Fair Haven Concerned Inc.) shall not be responsible for any injuries or losses sustained by me during my volunteering activities. I agree to be held solely responsible if my negligence, willful misconduct, or disregard for rules leads to damage to others or to Slate Valley Cares' property. I agree to hold harmless and indemnify and defend Slate Valley Cares against all claims, causes of action, damages, judgements, costs, property damage, or expenses including attorneys' fees and other litigation which in any way arise from my own or, if applicable, my family's use of, or presence within, or participation with Slate Valley Cares for the duration of my volunteer commitment. I agree and acknowledge that I am under no pressure or duress to sign this liability waiver and that I have been given a reasonable opportunity to review the form. 
Do you agree with the Release of Liability? *
Required
By signing (typing) your full name below, you attest to the accuracy of the information submitted on this Volunteer Application form, including: the Confidentiality Agreement, Volunteer Agreement, Automobile Insurance Statement, and Release of Liability. *
A copy of your responses will be emailed to the address you provided.
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