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Yes   No 

Please Check All That Apply

Please List Available Hours

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Volunteer Areas of Interest Please feel free to check all that apply.

Please list three people who know you well and can attest to your character, skills and dependability. Include your current or last employer.

Name/Organization

Relationship to You

Phone

Length of relationship

Volunteer Acknowledgements and Waivers

Volunteer hereby acknowledges that he/she is not an employee of New Generation, Inc. (Shelter,  Next Generation Infant & Toddler Center, or Second Generation Thrift Shoppes) 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.

Volunteer agrees to indemnify and hold harmless New Generation, Inc., (Shelter,  Next Generation Infant & Toddler Center, or Second Generation Thrift Shoppes) 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., (Shelter,  Next Generation Infant & Toddler Center, or Second Generation Thrift Shoppes) and/or its agents.

I Agree.

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

I understand that this is an application for and not a commitment or promise of volunteer opportunity. I certify that I have and will provide information throughout the selection process, including on this application for a volunteer position and in interviews with New Generation that is true, correct and complete to the best of my knowledge. I certify that I have and will answer all questions to the best of my ability and that I have not and will not withhold any information that would unfavorably affect my application for a volunteer position. I understand that information contained on my application will be verified by New Generation. I understand that misrepresentations or omissions may be cause for my immediate rejection as an applicant for a volunteer position with New Generation or my termination as a volunteer.

I Agree

Signature

Date

Signature of Parent or Legal Guardian if a minor

Date

Please Return this Form to:      New Generation, Inc.

                             PO Box 676

    Greenland, NH 03840

                             or email to office@newgeninc.org

568 Portsmouth Ave * Phone/Fax 603 436-4989 * www.newgennh.com *

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Last updated:  8/16/2007