Otsego County United Way
Volunteer Registration Form
Email address *
Full Name *
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Phone Number *
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Date of Birth *
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Ethnicity *
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Gender *
What would you like to help with?
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CONSENT AND CONFIDENTIALITY STATEMENT I volunteer my services through Otsego County United Way. I understand that I am not an employee of the agency. I hereby agree to regard all information received in the performance of my volunteer work as confidential. I further agree to respect individual rights to privacy, as well as those of the person, family and/or volunteer station for whom I am volunteering. I understand that the volunteer station will respect my rights regarding privacy of information. The volunteer station agrees to respect those rights in the performance of my volunteer duties and keep professional confidentiality in all my statements both inside and outside the station.I hereby grant permission for The Otsego County United Way to check with the appropriate authorities upon matters of record regarding my background and history as they relate to be a volunteer. I understand that if I use my personal automobile in my volunteer service, I will arrange to keep in effect automobile liability insurance equal to or greater than the minimum limits required by the State of Michigan.I agree to all the terms of this Volunteer Registration Form. I understand that all the information provided/obtained in this registration will be kept strictly confidential. *
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A copy of your responses will be emailed to the address you provided.
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