TCC Volunteer Application Step 1 of 4 25% Personal InformationName*Date of Birth*Phone Number*By providing a telephone number and submitting this form you are consenting to be contacted by SMS. Message frequency varies. Message and data rates may apply. Reply STOP to opt out of further messaging. Reply HELP for more information.Alternate Phone NumberBy providing a telephone number and submitting this form you are consenting to be contacted by SMS. Message frequency varies. Message and data rates may apply. Reply STOP to opt out of further messaging. Reply HELP for more information.Email* Address* Volunteer PreferencesDo you have a preference for the type of volunteer service you will be providing?* Yes No Specify preferred service(s) Assisting with fundraising Group volunteers for agency projects Photographing TCC events Grant writing Tutoring Designing promotional material Work force Planning and Network Advisory Committee Member Human Rights Committee Member Specially Constituted Committee Member Volunteer Services Council Board Member Spanish Interpreter Other Please describe other preferenceDo you feel comfortable having contact with clients?* Yes No With training, would you accept other assignments as a volunteer?* Yes No Volunteer AvailabilityPlease specify below when you would be available to serveMonday Not Available Anytime Mornings Afternoons Evenings Tuesday Not Available Anytime Mornings Afternoons Evenings Wednesday Not Available Anytime Mornings Afternoons Evenings Thursday Not Available Anytime Mornings Afternoons Evenings Friday Not Available Anytime Mornings Afternoons Evenings Saturday Not Available Anytime Mornings Afternoons Evenings Sunday Not Available Anytime Mornings Afternoons Evenings When are you able to start?* MM slash DD slash YYYY BackgroundDo you have any previous volunteer experience/training?* Yes No Please list previous experience/trainingAre you volunteering for the Veteran's program? Yes No Are you volunteering for class credit?* Yes No SchoolNumbers of hours neededInstructor's NameInstructor's emailInstructor's phone numberAre you court appointed?* Yes No Probation Officer's nameProbation Officer's addressProbation Officer's phone numberHave you worked with mentally ill adults?* Yes No Have you worked with intellectually disabled adults or children?* Yes No Are you currently employed?* Yes No Current employerJob TitleEmployer's addressEmployer's phone numberBy providing a telephone number and submitting this form you are consenting to be contacted by SMS. Message frequency varies. Message and data rates may apply. Reply STOP to opt out of further messaging. Reply HELP for more information.Previous employer, address, phone, length of service, job title, and supervisor*Highest level of education completed?* Elementary High School Vocational/Technical Training College Graduate School Other Please specify other educationWas degree received?* Yes No What field of study?Please list your skills, hobbies, interest, community activitiesDo you have access to transportation?* Yes No Have you ever been convicted by Federal, State, or any other law enforcement authorities for any violation of any Federal, State, or County Municipal law, regulation, or ordinance other than a minor traffic violation?* Yes No Please describePlease note, any criminal history that is a contradiction to working as a volunteer may result in denying approval of the applicant.ReferencesList three references with first and last name, full address, and telephone number. (Please do not list relatives)First Reference Name*Address*Phone Number*Second Reference Name*Address*Phone Number*Third Reference Name*Address*Phone Number*In case of an emergency, please notify* Volunteer Agreement I CONSENT TO A CRIMNAL BACKGROUND/HISTORY CHECK. I AFFIRM THAT THE INFORMATION THAT I HAVE PROVIDED IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE I AGREE TO CONFORM WITH TEXOMA COMMUNITY CENTER RULES AND REGULATIONS TO THE BEST OF MY ABILITY. I AGREE TO RESPECT THE CONFIDETIAL NATURE OF CASE INFORMATION AS WELL AS MY PERSONAL CONTACTS WITH CLIENTS. I AGREEE TO INFORM THE CENTER IF I AM NAMED IN COMPLAINTS OR INDICTMENTS OR CONVICTED OF OFFENSES. I UNDERSTAND THAT I WILL BE IN SERVICE ON A RECIPROCAL TRIAL BASIS AND AGREE TO PARTICIPATE IN ORINENTATION AND TRAINING I UNDERSTAND THAT I WILL NOT RECEIVE ANY MONETARY COOMPENSATION FOR MY VOLUNTEER SERVICES. Consent* I agree with the above statements
