Volunteer Application!
Today's Date *
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First Name *
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Middle Name *
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Last Name *
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Phone Number *
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Email *
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Address, City, Zip Code *
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Gender: *
Education: *
Indicate your age group: *
Occupation: *
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Please describe your experiences, if any, working with individuals with disabilities. *
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Have you ever been convicted, found guilty, entered a plea or nolo contendere (no contest), entered into a deferred prosecution or pre-trial intervention agreement, or had adjudication withheld in a criminal offense other than a minor traffic violation? (DUI is not a minor traffic violation). Are there any criminal charges pending against you? Sealed on expunged records must be reported pursuant to S.943.0598 F.S. *
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If your answer was yes to being convicted of a criminal offense, please indicate the following below: (Date of Arrest, City/State of Arrest, Nature of Charges) If answered yes, LTS Board of Directors must first provide approval prior to volunteering with LTS.
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Emergency Contact Information: Name, Cell Phone, Email: *
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Medical Release: I understand that in the event that I require medical treatment/services, LTS and affiliates will not be responsible for any medical expenses incurred, but that such expenses will be my responsibility. Please type your name on the line below that you understand and accept responsibility. *
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Photo Release: I give permission to be photographed and/or videotaped during the Life Academy Program. I understand the photographs will be used to keep a visual journal of activities as well as for promotional purposes including printed materials and on the internet. I understand that although my photograph may be used for advertising, my identity will not be disclosed. I do not expect to be compensated and understand that all photos are the property of LTS. Please type your name on the line below to indicate that you understand and agree. *
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Code of Conduct Agreement: All volunteers are expected to show respect towards all participants (Staff, Students, Parents, & Volunteers), and adhere to LTS guidelines. Please type your name on the line below to indicate that you understand and agree. *
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Dates of the Program: I understand that the Life Academy is a 10 month program from August 12, 2019 - May 29, 2020 and the beginning and ending dates coincide with the Alachua County Schools Calendar. However, the Life Academy has it's own calendar dates with regards to Holidays, which differs from the School Board Calendar. *
Holiday Policy: The Life Academy WILL NOT MEET on the following holiday dates: Sep 2- (Labor Day) / Oct 4- (UF Homecoming) / Nov 11- (Veterans Day) / Nov 25-29 (Thanksgiving) / Dec 23-Jan 3 (Winter Holidays) / Jan 20- (MLK Day) / May 25- (Memorial Day) *
Please review the Life Academy Daily Schedule. Click here to view our schedule: https://docs.google.com/document/d/1pWu_oeCeYaQeTF5DNr1PkHRpDjcfA80S42RR5d9f9Z8/edit?usp=sharing After reviewing the Life Academy schedule, I am available to volunteer on the following days & times: *
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After reviewing the Life Academy Schedule- Click Here: I would like to begin my volunteer experience on the following date & time(s):
I agree to all terms outlined in this document. Please type your name on the line below to indicate that you accept and agree. *
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How did you hear about LTS and/or the Life Academy? *
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Thank you very much for volunteering with LTS! We look forward to having you participate in the Life Academy as a volunteer! If you have any further questions, concerns, or comments, please feel free to write them below or contact LTS at lifetransitionskillsinc@gmail.com
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