Volunteer Application This application takes about 5-10 minutes to complete. An asterisk (*) appears next to all required fields. Reminder: CVCCS welcomes volunteers 18 years and older to serve in our warehouse. BASIC INFORMATIONName* First Last Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code On which phone numbers may we reach you?*Select all that apply. Home Phone Work Phone Cell Phone Home Phone*Work Phone*Cell Phone*Email Address* Birthday*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Special Needs / RequirementsPlease list any ways in which the Food Bank may need to accommodate you (allergies, physical restrictions, etc.)EMERGENCY CONTACT INFORMATIONName* First Last Home PhoneWork PhoneCell PhoneEmail Address Relationship*VOLUNTEER INTERESTSVolunteer Opportunities*Please indicate the types of project assignments that most interest you. Check all that apply. Clerical Offsite Distributions Pick-Ups/Deliveries Shopping for food or clothing with clients Sorting and Repackaging Food Sorting and hanging donated clothing Stocking Food shelves Other Please list special skills, certifications, or otherIf you are still employed, does your employer have a match or volunteer incentive program?Not ApplicableYesNoDon't KnowEMAIL PREFERENCESWe like to keep volunteers informed of important news, schedules, and volunteer opportunities by email, however we will not send you any email you prefer not to receive. Use the checkboxes below to select the kinds of email you would like to receive from us.What kinds of email would you like to receive? General Communication- Most common communication for volunteers. Critical to receive instructions or schedule changes. Volunteer Opportunities- Learn about upcoming volunteer opportunities at the Food Bank. Cancellations or Changes- Notifications of event cancellations or changes Electronic Newsletter- Periodic electronic newsletter to keep donors informed of various happenings at the Food Bank. Schedule Reminders- Convenient reminder of the dates and times you are scheduled to volunteer. LIABILITY AND PHOTO RELEASEBy submitting this application, I agree that I will not hold the Conestoga Valley Christian Community Services (CVCCS) or its employees, interns, officers, representatives, board of directors, or any fellow volunteers liable for accidents, injuries, or death to myself, my child, or any other person for whom I am lawful guardian, that may result from any volunteer activities by, arranged by, or participated in by CVCCS. Neither will I nor any person for whom I am lawful guardian, hold liable the persons who operate the Food Bank equipment during volunteer activities for accidents, injury, or death that may result from Food Bank activities. By submitting this application, I consent to be photographed or videotaped and agree to allow the Conestoga Valley Christian Community Services (CVCCS) to use any photo or video to be used for future promotional purposes. I understand that I will receive no remuneration in the event that any photographs, images, actions, or voice are used in Food Bank brochures, advertisements, or visual presentations. Further, I understand the context in which my photo or video may appear in this promotion/publication, and also consent for all purposes of reproduction or use of this photo or video by the Food Bank in all manners. I further understand that the material may not be used at all. Finally, I release the designer(s), photographer(s), their nominees and designees of any personal and proprietary rights that I may have with, or in, the distribution or use of this photo reproduction. Your IP Address Is: 220.127.116.11By selecting the box below you confirm that you have read and agree to the "LIABILITY AND PHOTO RELEASE" above.* I Agree.