Volunteer Application

Please fill in the form below and then click submit. If you have immediate questions or concerns please call us at (509) 853-1917.

Name *

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Last

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Address Line 2

City

State

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Date of Birth: (for background check) *

Home Phone

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Single Line Text

References (non-family)

Reference #1 Name *

First

Last

Relationship *

Phone *

United States+1
United Kingdom+44
Afghanistan (‫افغانستان‬‎)+93
Albania (Shqipëri)+355
Algeria (‫الجزائر‬‎)+213
American Samoa+1
Andorra+376
Angola+244
Anguilla+1
Antigua and Barbuda+1
Argentina+54
Armenia (Հայաստան)+374
Aruba+297
Ascension Island+247
Australia+61
Austria (Österreich)+43
Azerbaijan (Azərbaycan)+994
Bahamas+1
Bahrain (‫البحرين‬‎)+973
Bangladesh (বাংলাদেশ)+880
Barbados+1
Belarus (Беларусь)+375
Belgium (België)+32
Belize+501
Benin (Bénin)+229
Bermuda+1
Bhutan (འབྲུག)+975
Bolivia+591
Bosnia and Herzegovina (Босна и Херцеговина)+387
Botswana+267
Brazil (Brasil)+55
British Indian Ocean Territory+246
British Virgin Islands+1
Brunei+673
Bulgaria (България)+359
Burkina Faso+226
Burundi (Uburundi)+257
Cambodia (កម្ពុជា)+855
Cameroon (Cameroun)+237
Canada+1
Cape Verde (Kabu Verdi)+238
Caribbean Netherlands+599
Cayman Islands+1
Central African Republic (République centrafricaine)+236
Chad (Tchad)+235
Chile+56
China (中国)+86
Christmas Island+61
Cocos (Keeling) Islands+61
Colombia+57
Comoros (‫جزر القمر‬‎)+269
Congo (DRC) (Jamhuri ya Kidemokrasia ya Kongo)+243
Congo (Republic) (Congo-Brazzaville)+242
Cook Islands+682
Costa Rica+506
Côte d’Ivoire+225
Croatia (Hrvatska)+385
Cuba+53
Curaçao+599
Cyprus (Κύπρος)+357
Czech Republic (Česká republika)+420
Denmark (Danmark)+45
Djibouti+253
Dominica+1
Dominican Republic (República Dominicana)+1
Ecuador+593
Egypt (‫مصر‬‎)+20
El Salvador+503
Equatorial Guinea (Guinea Ecuatorial)+240
Eritrea+291
Estonia (Eesti)+372
Eswatini+268
Ethiopia+251
Falkland Islands (Islas Malvinas)+500
Faroe Islands (Føroyar)+298
Fiji+679
Finland (Suomi)+358
France+33
French Guiana (Guyane française)+594
French Polynesia (Polynésie française)+689
Gabon+241
Gambia+220
Georgia (საქართველო)+995
Germany (Deutschland)+49
Ghana (Gaana)+233
Gibraltar+350
Greece (Ελλάδα)+30
Greenland (Kalaallit Nunaat)+299
Grenada+1
Guadeloupe+590
Guam+1
Guatemala+502
Guernsey+44
Guinea (Guinée)+224
Guinea-Bissau (Guiné Bissau)+245
Guyana+592
Haiti+509
Honduras+504
Hong Kong (香港)+852
Hungary (Magyarország)+36
Iceland (Ísland)+354
India (भारत)+91
Indonesia+62
Iran (‫ایران‬‎)+98
Iraq (‫العراق‬‎)+964
Ireland+353
Isle of Man+44
Israel (‫ישראל‬‎)+972
Italy (Italia)+39
Jamaica+1
Japan (日本)+81
Jersey+44
Jordan (‫الأردن‬‎)+962
Kazakhstan (Казахстан)+7
Kenya+254
Kiribati+686
Kosovo+383
Kuwait (‫الكويت‬‎)+965
Kyrgyzstan (Кыргызстан)+996
Laos (ລາວ)+856
Latvia (Latvija)+371
Lebanon (‫لبنان‬‎)+961
Lesotho+266
Liberia+231
Libya (‫ليبيا‬‎)+218
Liechtenstein+423
Lithuania (Lietuva)+370
Luxembourg+352
Macau (澳門)+853
North Macedonia (Македонија)+389
Madagascar (Madagasikara)+261
Malawi+265
Malaysia+60
Maldives+960
Mali+223
Malta+356
Marshall Islands+692
Martinique+596
Mauritania (‫موريتانيا‬‎)+222
Mauritius (Moris)+230
Mayotte+262
Mexico (México)+52
Micronesia+691
Moldova (Republica Moldova)+373
Monaco+377
Mongolia (Монгол)+976
Montenegro (Crna Gora)+382
Montserrat+1
Morocco (‫المغرب‬‎)+212
Mozambique (Moçambique)+258
Myanmar (Burma) (မြန်မာ)+95
Namibia (Namibië)+264
Nauru+674
Nepal (नेपाल)+977
Netherlands (Nederland)+31
New Caledonia (Nouvelle-Calédonie)+687
New Zealand+64
Nicaragua+505
Niger (Nijar)+227
Nigeria+234
Niue+683
Norfolk Island+672
North Korea (조선 민주주의 인민 공화국)+850
Northern Mariana Islands+1
Norway (Norge)+47
Oman (‫عُمان‬‎)+968
Pakistan (‫پاکستان‬‎)+92
Palau+680
Palestine (‫فلسطين‬‎)+970
Panama (Panamá)+507
Papua New Guinea+675
Paraguay+595
Peru (Perú)+51
Philippines+63
Poland (Polska)+48
Portugal+351
Puerto Rico+1
Qatar (‫قطر‬‎)+974
Réunion (La Réunion)+262
Romania (România)+40
Russia (Россия)+7
Rwanda+250
Saint Barthélemy+590
Saint Helena+290
Saint Kitts and Nevis+1
Saint Lucia+1
Saint Martin (Saint-Martin (partie française))+590
Saint Pierre and Miquelon (Saint-Pierre-et-Miquelon)+508
Saint Vincent and the Grenadines+1
Samoa+685
San Marino+378
São Tomé and Príncipe (São Tomé e Príncipe)+239
Saudi Arabia (‫المملكة العربية السعودية‬‎)+966
Senegal (Sénégal)+221
Serbia (Србија)+381
Seychelles+248
Sierra Leone+232
Singapore+65
Sint Maarten+1
Slovakia (Slovensko)+421
Slovenia (Slovenija)+386
Solomon Islands+677
Somalia (Soomaaliya)+252
South Africa+27
South Korea (대한민국)+82
South Sudan (‫جنوب السودان‬‎)+211
Spain (España)+34
Sri Lanka (ශ්‍රී ලංකාව)+94
Sudan (‫السودان‬‎)+249
Suriname+597
Svalbard and Jan Mayen+47
Sweden (Sverige)+46
Switzerland (Schweiz)+41
Syria (‫سوريا‬‎)+963
Taiwan (台灣)+886
Tajikistan+992
Tanzania+255
Thailand (ไทย)+66
Timor-Leste+670
Togo+228
Tokelau+690
Tonga+676
Trinidad and Tobago+1
Tunisia (‫تونس‬‎)+216
Turkey (Türkiye)+90
Turkmenistan+993
Turks and Caicos Islands+1
Tuvalu+688
U.S. Virgin Islands+1
Uganda+256
Ukraine (Україна)+380
United Arab Emirates (‫الإمارات العربية المتحدة‬‎)+971
United Kingdom+44
United States+1
Uruguay+598
Uzbekistan (Oʻzbekiston)+998
Vanuatu+678
Vatican City (Città del Vaticano)+39
Venezuela+58
Vietnam (Việt Nam)+84
Wallis and Futuna (Wallis-et-Futuna)+681
Western Sahara (‫الصحراء الغربية‬‎)+212
Yemen (‫اليمن‬‎)+967
Zambia+260
Zimbabwe+263
Åland Islands+358

Reference #2 Name *

First

Last

Relationship

Phone

United States+1
United Kingdom+44
Afghanistan (‫افغانستان‬‎)+93
Albania (Shqipëri)+355
Algeria (‫الجزائر‬‎)+213
American Samoa+1
Andorra+376
Angola+244
Anguilla+1
Antigua and Barbuda+1
Argentina+54
Armenia (Հայաստան)+374
Aruba+297
Ascension Island+247
Australia+61
Austria (Österreich)+43
Azerbaijan (Azərbaycan)+994
Bahamas+1
Bahrain (‫البحرين‬‎)+973
Bangladesh (বাংলাদেশ)+880
Barbados+1
Belarus (Беларусь)+375
Belgium (België)+32
Belize+501
Benin (Bénin)+229
Bermuda+1
Bhutan (འབྲུག)+975
Bolivia+591
Bosnia and Herzegovina (Босна и Херцеговина)+387
Botswana+267
Brazil (Brasil)+55
British Indian Ocean Territory+246
British Virgin Islands+1
Brunei+673
Bulgaria (България)+359
Burkina Faso+226
Burundi (Uburundi)+257
Cambodia (កម្ពុជា)+855
Cameroon (Cameroun)+237
Canada+1
Cape Verde (Kabu Verdi)+238
Caribbean Netherlands+599
Cayman Islands+1
Central African Republic (République centrafricaine)+236
Chad (Tchad)+235
Chile+56
China (中国)+86
Christmas Island+61
Cocos (Keeling) Islands+61
Colombia+57
Comoros (‫جزر القمر‬‎)+269
Congo (DRC) (Jamhuri ya Kidemokrasia ya Kongo)+243
Congo (Republic) (Congo-Brazzaville)+242
Cook Islands+682
Costa Rica+506
Côte d’Ivoire+225
Croatia (Hrvatska)+385
Cuba+53
Curaçao+599
Cyprus (Κύπρος)+357
Czech Republic (Česká republika)+420
Denmark (Danmark)+45
Djibouti+253
Dominica+1
Dominican Republic (República Dominicana)+1
Ecuador+593
Egypt (‫مصر‬‎)+20
El Salvador+503
Equatorial Guinea (Guinea Ecuatorial)+240
Eritrea+291
Estonia (Eesti)+372
Eswatini+268
Ethiopia+251
Falkland Islands (Islas Malvinas)+500
Faroe Islands (Føroyar)+298
Fiji+679
Finland (Suomi)+358
France+33
French Guiana (Guyane française)+594
French Polynesia (Polynésie française)+689
Gabon+241
Gambia+220
Georgia (საქართველო)+995
Germany (Deutschland)+49
Ghana (Gaana)+233
Gibraltar+350
Greece (Ελλάδα)+30
Greenland (Kalaallit Nunaat)+299
Grenada+1
Guadeloupe+590
Guam+1
Guatemala+502
Guernsey+44
Guinea (Guinée)+224
Guinea-Bissau (Guiné Bissau)+245
Guyana+592
Haiti+509
Honduras+504
Hong Kong (香港)+852
Hungary (Magyarország)+36
Iceland (Ísland)+354
India (भारत)+91
Indonesia+62
Iran (‫ایران‬‎)+98
Iraq (‫العراق‬‎)+964
Ireland+353
Isle of Man+44
Israel (‫ישראל‬‎)+972
Italy (Italia)+39
Jamaica+1
Japan (日本)+81
Jersey+44
Jordan (‫الأردن‬‎)+962
Kazakhstan (Казахстан)+7
Kenya+254
Kiribati+686
Kosovo+383
Kuwait (‫الكويت‬‎)+965
Kyrgyzstan (Кыргызстан)+996
Laos (ລາວ)+856
Latvia (Latvija)+371
Lebanon (‫لبنان‬‎)+961
Lesotho+266
Liberia+231
Libya (‫ليبيا‬‎)+218
Liechtenstein+423
Lithuania (Lietuva)+370
Luxembourg+352
Macau (澳門)+853
North Macedonia (Македонија)+389
Madagascar (Madagasikara)+261
Malawi+265
Malaysia+60
Maldives+960
Mali+223
Malta+356
Marshall Islands+692
Martinique+596
Mauritania (‫موريتانيا‬‎)+222
Mauritius (Moris)+230
Mayotte+262
Mexico (México)+52
Micronesia+691
Moldova (Republica Moldova)+373
Monaco+377
Mongolia (Монгол)+976
Montenegro (Crna Gora)+382
Montserrat+1
Morocco (‫المغرب‬‎)+212
Mozambique (Moçambique)+258
Myanmar (Burma) (မြန်မာ)+95
Namibia (Namibië)+264
Nauru+674
Nepal (नेपाल)+977
Netherlands (Nederland)+31
New Caledonia (Nouvelle-Calédonie)+687
New Zealand+64
Nicaragua+505
Niger (Nijar)+227
Nigeria+234
Niue+683
Norfolk Island+672
North Korea (조선 민주주의 인민 공화국)+850
Northern Mariana Islands+1
Norway (Norge)+47
Oman (‫عُمان‬‎)+968
Pakistan (‫پاکستان‬‎)+92
Palau+680
Palestine (‫فلسطين‬‎)+970
Panama (Panamá)+507
Papua New Guinea+675
Paraguay+595
Peru (Perú)+51
Philippines+63
Poland (Polska)+48
Portugal+351
Puerto Rico+1
Qatar (‫قطر‬‎)+974
Réunion (La Réunion)+262
Romania (România)+40
Russia (Россия)+7
Rwanda+250
Saint Barthélemy+590
Saint Helena+290
Saint Kitts and Nevis+1
Saint Lucia+1
Saint Martin (Saint-Martin (partie française))+590
Saint Pierre and Miquelon (Saint-Pierre-et-Miquelon)+508
Saint Vincent and the Grenadines+1
Samoa+685
San Marino+378
São Tomé and Príncipe (São Tomé e Príncipe)+239
Saudi Arabia (‫المملكة العربية السعودية‬‎)+966
Senegal (Sénégal)+221
Serbia (Србија)+381
Seychelles+248
Sierra Leone+232
Singapore+65
Sint Maarten+1
Slovakia (Slovensko)+421
Slovenia (Slovenija)+386
Solomon Islands+677
Somalia (Soomaaliya)+252
South Africa+27
South Korea (대한민국)+82
South Sudan (‫جنوب السودان‬‎)+211
Spain (España)+34
Sri Lanka (ශ්‍රී ලංකාව)+94
Sudan (‫السودان‬‎)+249
Suriname+597
Svalbard and Jan Mayen+47
Sweden (Sverige)+46
Switzerland (Schweiz)+41
Syria (‫سوريا‬‎)+963
Taiwan (台灣)+886
Tajikistan+992
Tanzania+255
Thailand (ไทย)+66
Timor-Leste+670
Togo+228
Tokelau+690
Tonga+676
Trinidad and Tobago+1
Tunisia (‫تونس‬‎)+216
Turkey (Türkiye)+90
Turkmenistan+993
Turks and Caicos Islands+1
Tuvalu+688
U.S. Virgin Islands+1
Uganda+256
Ukraine (Україна)+380
United Arab Emirates (‫الإمارات العربية المتحدة‬‎)+971
United Kingdom+44
United States+1
Uruguay+598
Uzbekistan (Oʻzbekiston)+998
Vanuatu+678
Vatican City (Città del Vaticano)+39
Venezuela+58
Vietnam (Việt Nam)+84
Wallis and Futuna (Wallis-et-Futuna)+681
Western Sahara (‫الصحراء الغربية‬‎)+212
Yemen (‫اليمن‬‎)+967
Zambia+260
Zimbabwe+263
Åland Islands+358

Emergency Contact Information

*Preferably local

Name *

First

Last

Relationship *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

United States+1
United Kingdom+44
Afghanistan (‫افغانستان‬‎)+93
Albania (Shqipëri)+355
Algeria (‫الجزائر‬‎)+213
American Samoa+1
Andorra+376
Angola+244
Anguilla+1
Antigua and Barbuda+1
Argentina+54
Armenia (Հայաստան)+374
Aruba+297
Ascension Island+247
Australia+61
Austria (Österreich)+43
Azerbaijan (Azərbaycan)+994
Bahamas+1
Bahrain (‫البحرين‬‎)+973
Bangladesh (বাংলাদেশ)+880
Barbados+1
Belarus (Беларусь)+375
Belgium (België)+32
Belize+501
Benin (Bénin)+229
Bermuda+1
Bhutan (འབྲུག)+975
Bolivia+591
Bosnia and Herzegovina (Босна и Херцеговина)+387
Botswana+267
Brazil (Brasil)+55
British Indian Ocean Territory+246
British Virgin Islands+1
Brunei+673
Bulgaria (България)+359
Burkina Faso+226
Burundi (Uburundi)+257
Cambodia (កម្ពុជា)+855
Cameroon (Cameroun)+237
Canada+1
Cape Verde (Kabu Verdi)+238
Caribbean Netherlands+599
Cayman Islands+1
Central African Republic (République centrafricaine)+236
Chad (Tchad)+235
Chile+56
China (中国)+86
Christmas Island+61
Cocos (Keeling) Islands+61
Colombia+57
Comoros (‫جزر القمر‬‎)+269
Congo (DRC) (Jamhuri ya Kidemokrasia ya Kongo)+243
Congo (Republic) (Congo-Brazzaville)+242
Cook Islands+682
Costa Rica+506
Côte d’Ivoire+225
Croatia (Hrvatska)+385
Cuba+53
Curaçao+599
Cyprus (Κύπρος)+357
Czech Republic (Česká republika)+420
Denmark (Danmark)+45
Djibouti+253
Dominica+1
Dominican Republic (República Dominicana)+1
Ecuador+593
Egypt (‫مصر‬‎)+20
El Salvador+503
Equatorial Guinea (Guinea Ecuatorial)+240
Eritrea+291
Estonia (Eesti)+372
Eswatini+268
Ethiopia+251
Falkland Islands (Islas Malvinas)+500
Faroe Islands (Føroyar)+298
Fiji+679
Finland (Suomi)+358
France+33
French Guiana (Guyane française)+594
French Polynesia (Polynésie française)+689
Gabon+241
Gambia+220
Georgia (საქართველო)+995
Germany (Deutschland)+49
Ghana (Gaana)+233
Gibraltar+350
Greece (Ελλάδα)+30
Greenland (Kalaallit Nunaat)+299
Grenada+1
Guadeloupe+590
Guam+1
Guatemala+502
Guernsey+44
Guinea (Guinée)+224
Guinea-Bissau (Guiné Bissau)+245
Guyana+592
Haiti+509
Honduras+504
Hong Kong (香港)+852
Hungary (Magyarország)+36
Iceland (Ísland)+354
India (भारत)+91
Indonesia+62
Iran (‫ایران‬‎)+98
Iraq (‫العراق‬‎)+964
Ireland+353
Isle of Man+44
Israel (‫ישראל‬‎)+972
Italy (Italia)+39
Jamaica+1
Japan (日本)+81
Jersey+44
Jordan (‫الأردن‬‎)+962
Kazakhstan (Казахстан)+7
Kenya+254
Kiribati+686
Kosovo+383
Kuwait (‫الكويت‬‎)+965
Kyrgyzstan (Кыргызстан)+996
Laos (ລາວ)+856
Latvia (Latvija)+371
Lebanon (‫لبنان‬‎)+961
Lesotho+266
Liberia+231
Libya (‫ليبيا‬‎)+218
Liechtenstein+423
Lithuania (Lietuva)+370
Luxembourg+352
Macau (澳門)+853
North Macedonia (Македонија)+389
Madagascar (Madagasikara)+261
Malawi+265
Malaysia+60
Maldives+960
Mali+223
Malta+356
Marshall Islands+692
Martinique+596
Mauritania (‫موريتانيا‬‎)+222
Mauritius (Moris)+230
Mayotte+262
Mexico (México)+52
Micronesia+691
Moldova (Republica Moldova)+373
Monaco+377
Mongolia (Монгол)+976
Montenegro (Crna Gora)+382
Montserrat+1
Morocco (‫المغرب‬‎)+212
Mozambique (Moçambique)+258
Myanmar (Burma) (မြန်မာ)+95
Namibia (Namibië)+264
Nauru+674
Nepal (नेपाल)+977
Netherlands (Nederland)+31
New Caledonia (Nouvelle-Calédonie)+687
New Zealand+64
Nicaragua+505
Niger (Nijar)+227
Nigeria+234
Niue+683
Norfolk Island+672
North Korea (조선 민주주의 인민 공화국)+850
Northern Mariana Islands+1
Norway (Norge)+47
Oman (‫عُمان‬‎)+968
Pakistan (‫پاکستان‬‎)+92
Palau+680
Palestine (‫فلسطين‬‎)+970
Panama (Panamá)+507
Papua New Guinea+675
Paraguay+595
Peru (Perú)+51
Philippines+63
Poland (Polska)+48
Portugal+351
Puerto Rico+1
Qatar (‫قطر‬‎)+974
Réunion (La Réunion)+262
Romania (România)+40
Russia (Россия)+7
Rwanda+250
Saint Barthélemy+590
Saint Helena+290
Saint Kitts and Nevis+1
Saint Lucia+1
Saint Martin (Saint-Martin (partie française))+590
Saint Pierre and Miquelon (Saint-Pierre-et-Miquelon)+508
Saint Vincent and the Grenadines+1
Samoa+685
San Marino+378
São Tomé and Príncipe (São Tomé e Príncipe)+239
Saudi Arabia (‫المملكة العربية السعودية‬‎)+966
Senegal (Sénégal)+221
Serbia (Србија)+381
Seychelles+248
Sierra Leone+232
Singapore+65
Sint Maarten+1
Slovakia (Slovensko)+421
Slovenia (Slovenija)+386
Solomon Islands+677
Somalia (Soomaaliya)+252
South Africa+27
South Korea (대한민국)+82
South Sudan (‫جنوب السودان‬‎)+211
Spain (España)+34
Sri Lanka (ශ්‍රී ලංකාව)+94
Sudan (‫السودان‬‎)+249
Suriname+597
Svalbard and Jan Mayen+47
Sweden (Sverige)+46
Switzerland (Schweiz)+41
Syria (‫سوريا‬‎)+963
Taiwan (台灣)+886
Tajikistan+992
Tanzania+255
Thailand (ไทย)+66
Timor-Leste+670
Togo+228
Tokelau+690
Tonga+676
Trinidad and Tobago+1
Tunisia (‫تونس‬‎)+216
Turkey (Türkiye)+90
Turkmenistan+993
Turks and Caicos Islands+1
Tuvalu+688
U.S. Virgin Islands+1
Uganda+256
Ukraine (Україна)+380
United Arab Emirates (‫الإمارات العربية المتحدة‬‎)+971
United Kingdom+44
United States+1
Uruguay+598
Uzbekistan (Oʻzbekiston)+998
Vanuatu+678
Vatican City (Città del Vaticano)+39
Venezuela+58
Vietnam (Việt Nam)+84
Wallis and Futuna (Wallis-et-Futuna)+681
Western Sahara (‫الصحراء الغربية‬‎)+212
Yemen (‫اليمن‬‎)+967
Zambia+260
Zimbabwe+263
Åland Islands+358

Additional Information

Availability - Please list preferred days of week and time of day *

Example: Monday and Wednesday mornings, Friday afternoons

Volunteer Interests: Please check ALL that apply. *

Driving – rides to Dr. visits, shopping, etc.
Occasional Light house cleaning
Sorting mail, bills, etc.
Occasional light gardening, yard work
In home visiting
Daily phone call check-in
Walking/exercise partner
Computer/web assistance
Social media support
TV, Cable, A/V Assistance
T.V., Cable, A/V Assistance
Data Entry
Fundraising
Marketing/Outreach
Telephoning
Flyer/Poster Distribution
House Party/Info Session Host
Photography
Event Support
Social Event Planner
Teaching Class
Lecture/Talk

Please provide any other information that you think is relevant

Examples: Worked with blind people, master gardener, love of music, etc. Anything that would help match you to members.

Motor Vehicle Record Information

(only required for volunteers providing transportation)

Within the past 5 years, have you been ticketed for any of the following?

Moving Violation
Aggressive Driving
At Fault Accident
Reckless Driving
DUI (past 15 yrs.)

Upload a copy of insurance card for your vehicle

Click or drag a file to this area to upload.

Upload a copy of driver's license

Click or drag a file to this area to upload.

Release of Liability & Volunteer Agreement & Photo Release

By submitting this application, I affirm that the facts set forth in it are try and complete. By initialing statements below, I agree to the following YSNN policies:

I will offer my time without monetary compensation.

I understand that my own personal or professional business will not benefit financially or in any other way from the volunteer service that I will perform.

I agree to conform to all of the YSNN procedures and regulations.

I understand that if I am accepted as a volunteer, any false statements, omissions, or other misrepresentations made by me on this application may result in dismissal.

I authorize YSNN to contact my references and perform a background check

I agree to indemnify YSNN against and hold it harmless from all loss and expense arising out of any act, neglect or fault on my part.

I agree to fill out a volunteer service report within 2 days of each volunteer service

Finally, as a YSNN volunteer, I understand it is imperative to protect the confidentiality of all information pertaining to any YSNN member, non-member, volunteer or client associated with YSNN, including any identifying information about them, including the unauthorized possession, use, copying, reading or disclosure of applicable records, ledgers or files.

Submitting this form indicates your agreement to adhere to YSNN’s volunteer agreement if placed as a volunteer.

YSNN is not obligated to provide a placement, nor are you obligated to accept the position offered. The information you have submitted will not be given to any other parties without your permission.

Volunteers are covered through the state for industrial insurance (workman’s comp) and in order to report your hours and have you covered, your social security number is needed.

I have read the volunteer policies document and agree to its terms.

I certify that the information given on this form is accurate to the best of my knowledge.

Lastly, from time to time, YSNN may use still photos or video images of our members as well as volunteers for marketing the organization and/or on our website. May we use photographs taken of you while on volunteer duty? *

Signature *

First

Last

By typing your name, you are virtually signing this application.

Social Security Number (for L&I) *