Volunteer Application

Name:  
Address:  
City:  
State:  
Zip Code:
  
Home Phone:  
Employer:  
Work Phone:   Cell Phone:  
Email Address:  
Driver’s License #:  
License Plate #:  

I would like to receive your newsletter: ________

Please Check All That Apply

  

Please List Available Hours
    Adult (36-55)

Sunday

    
  Young Adult (20-35)

Monday

  
  Senior

Tuesday

  
  Parent

Wednesday

  
  Grandparent

Thursday

  
  Teenager

Friday

  
   

Saturday

  

Volunteer Areas of Interest

Please feel free to check all that apply.
  Substitute Staff   Collecting Food & Paper Products
  Transportation   Gardening & Yard Work
  Special Events Coordinator   Moving Help (with Truck)
  Mailings (and other Office Work)   Car Maintenance
  Newsletter   General Construction
  Fundraising   House Maintenance
  Craft/Homemaker Instructor   Washing Windows
  Tutoring for GED   Painting
  Decorating Advisor   Child Care (Next Generation)
  Parent/Health Presentations   Thrift Shoppe (Second Generation)
  Other Please Specify:  

Please List 3 References
Name:   Name:   Name:  
Address:   Address:   Address:  
City:   City:   City:  
State:   State:   State:  
Zip Code:   Zip Code:   Zip Code:  
Phone:   Phone:   Phone:  
Relationship   Relationship   Relationship  

 

 

Volunteer Acknowledgements and Waivers
Volunteers must acknowledge and agree with the following. Please initial the appropriate box below to indicate agreement and/or acknowledgement. (Signature of Parent or Legal Guardian required if Volunteer is a minor.)
Volunteer Statement

Volunteer hereby acknowledges that he/she is not an employee of New Generation, Inc., Next Generation, Inc., or Second Generation, Inc. or its agents but is an unpaid volunteer and is therefore not entitled to Worker’s Compensation or any other benefits typically extended to employees. The Volunteer also acknowledges that this volunteer position might not necessarily lead to a paid position.

 

_______

I Acknowledge.
Liability Waiver

Volunteer agrees to indemnify and hold harmless New Generation, Inc., Next Generation, Inc., or Second Generation, Inc. and employees, directors, residents, attorneys and agents to the fullest extent permitted by law from any and all liabilities, injuries, losses, or damages of any kind sustained as a result of any activity connected with their self or their child(ren) volunteering including but not limited to injuries caused in whole or in part by any negligent act or omission of New Generation, Inc., Next Generation, Inc., or Second Generation, Inc and/or its agents.

 

 

_________

I Agree.
Confidentiality Acknowledgement

Volunteer agrees that he/she shall respect the privacy concerns of our clients and shall hold in confidence all information obtained in the course of volunteering, whether that information is obtained through written records or daily interactions with clients. Therefore, the Volunteer will not disclose an individual’s situation or confidence to anyone, except: 1) as mandated by law; 2) to prevent a clear and immediate danger to a person or persons; 3) where compelled to do so by a court or pursuant to the rules of a court. The Volunteer agrees to store and dispose of professional records in ways to ensure confidentiality. The Volunteer shall possess a professional attitude which upholds confidentiality towards our clients, colleagues, applicants and any sensitive situations arising within New Generation. This confidentiality shall be maintained throughout the course of the Volunteers service and continue upon separation. Volunteer understands that violation of confidentiality statement may be grounds for immediate removal from service.

 

 

__________

I Acknowledge

 

                           

                             Signature                                                                Date          

 

Please Return this Form to:   

 New Generation, Inc.
PO Box 676 / 568 Portsmouth Ave.
Greenland, NH 03840
                                                            

House Needs

Office Needs

Thrift Shoppe Needs
· Paper Products – Single-ply toilet paper, paper towels, napkins, tissues, plates & cups

· Plastic Ware

· Cleaning Products (Liquid Laundry, Dish Soap, Dishwasher Soap, etc.)

· Single Sheets, Blankets & Bedspreads

· Kitchen towels / dishcloths

· Canned non-perishable food

 · Copier paper

· Black / Red Pens

· Yellow Highlighters

· Postage Stamps

· Ink Cartridges

 · Baby Items

· Clothing (all sizes)

· Accessories

· Household items

· Furniture

Day Care Needs
· Preschool books/tapes/videos

· Drawing Paper

· Preschool Crayons

Please call our office if you are able to help us. Phone/Fax 603 436-4989

New Generation Office