RECFORM Under 18 Nacogdoches Recreation Volunteer Application (Official)

PERSONAL INFORMATION
A government issued; photo identification must be submitted with application
Applicant
Date
Applicant's First Name *
Applicant's Last Name *
Street Address *
City *
State *
Apartment Number (if applicable)
Zip Code *
Phone Number *
Alternate Phone Number *
Email Address * Please enter correctly as this is the main way we will contact you
Emergency Contact:
Name:
Emergency contact phone:
Education & Military Experience
Highest level of education completed:
High School Name:
High School City/State:
College Name:
College City/State:
Degrees or Certificates Earned:
Military Service Branch:
Specialty Training:
Employment History (please list two (2) most recent jobs)
Date From:
Date To:
Company:
Job Duties:
Date From:
Date to:
Company:
Job Duties:
Volunteer Interest
Why are you interested in volunteering for the City of Nacogdoches?
What other volunteer work have you done?
Do you have any special skills or experience to share as a volunteer?
What volunteer opportunities interest you?
What are you volunteering for today?
When will you be available to volunteer?	Monday Tuesday Wednesday Thursday Friday Saturday
Do you speak or write a language other than English?
If yes, what language(s)
Have you ever been charged with or have charges pending for an offense that resulted in or may result in a conviction, probation, community supervision or deferred adjudication?
Have you ever worked or volunteered for the City of Nacogdoches?
Are you related to anyone working for the City of Nacogdoches
Are you 18 years of age or older?


Volunteer Name (printed)
Volunteer Signature *
Date:

I understand that I am not applying to be an employee of the City of Nacogdoches. I understand that I will not receive any form of compensation or remuneration for these volunteer services. I further acknowledge that I am a volunteer for purposes of the Fair Labor Standards Act. I wish to volunteer my services to the City of Nacogdoches. *
I understand that I will be required to comply with all of the City's rules, policies and regulations. *
I understand and agree that the City may at its discretion discontinue my volunteer services at any time and without prior or written notice, and without cause or reason. *
I understand that during my volunteering activities or related activities, I may be recorded, photographed or video taped. I agree to allow any record, including, but not limited to, photographs, video and film, of my likeness to be used by the City at any time and for any purpose. *
I understand the City of Nacogdoches reserves the right to decline any applicant for a volunteer position with the City of Nacogdoches who has been convicted of, or charged with a felony, has been convicted of or charged with a criime involving a sex offense or child abuse or has engaged in any other conduct or pattern of conduct that would disrupt, diminish or otherwise jeopardize public trust in the offices of the City of Nacogdoches. *
The City will review all applications fairly and honestly. Any commission of the listed behavior does not mean the applicant will be automatically disqualified. However, we will conduct a criminal background check in conjunction with you volunteer application; the consent form for the background check is attached. Once you are approved to volunteer with the city, you will be required to attend an orientation session before you can begin volunteering.
Volunteers must notify the City of Nacogdoches of any injury that occurs while performing volunteer duties for the City of Nacogdoches. The city is a member of the Deep East Texas Self Insurance Fund and volunteers must seek treatment for an on-the-job injury. Therefore, injured volunteers must immediately report to their supervisor or contact Human Resources at (936) 559-2567. Once the injury is reported the volunteer may be required to submit to and successfully pass a drug test by a laboratory selected by and at the expense of the City in case of serious accident or injury. *
If any activity to which I am assigned presents risks that I do not feel comfortable with, then it is my responsibility to state that concern to the applicable City employee or volunteer coordinator and announce my decision not to engage in that activity. *
I agree to abide by all safety rules that are applicable at the site in which I am performing volunteer duties, to properly use any personal protective equipment that may be provided to me, and will always perform volunteer activities in a safe and prudent manner. *
I agree to dress appropriately for the volunteer services performed. *
I agree to be respectful and professional. *
I authorize the City to investigate my background as part of the screening process to determine my suitability as a potential volunteer. I authorize the City to secure the following record checks: Social Security number verification; criminal records from the court jurisdiction in which I currently reside and work; state criminal records; FBI or other national criminal database; National Sex Offender Registry; and Child Abuse Registry or Child Protective services check where permissible by law. I give my permission for my references to be checked which may include past employers, volunteer organizations, and personal references. I understand that all the information will be held in strict confidence and used only for the purpose of determining my suitability as a volunteer. *
Note: The City of Nacogdoches shall not discriminate against any applicant due to age, sex, marital status, national origin, religeonk race, disability or other protected group under federal, state, or local law. The City of Nacogdoches supports a drug and alcohol-free workplace policy.

Volunteer Name (Printed)
Volunteer Signature: *
Parent or Guardian: (If applicant is under the age of 18)
Signature:
Date:
Printed Name:
Driver's License or ID: *
Please ensure that the application is complete before submitting, as the document cannot be edited once it has been submitted

RECFORM Under 18 Nacogdoches Recreation Volunteer Application (Official)

PERSONAL INFORMATION

A government issued; photo identification must be submitted with application

Applicant

Emergency Contact:

Education & Military Experience

Employment History (please list two (2) most recent jobs)

Volunteer Interest

Note: The City of Nacogdoches shall not discriminate against any applicant due to age, sex, marital status, national origin, religeonk race, disability or other protected group under federal, state, or local law. The City of Nacogdoches supports a drug and alcohol-free workplace policy.

Parent or Guardian: (If applicant is under the age of 18)

Please ensure that the application is complete before submitting, as the document cannot be edited once it has been submitted