Volunteer Application - Project Hospitality

Name

First

Last

Street Address

City

State

Zip Code

Telephone

Email

Date Of Birth

If applying to fulfill a community service requirement for school or court:

Please Include: School, Program, Contact Person, Tel Number, # Hours Needed

Availability: When will you be able to start?

Days & Hours (from/to) available:

ex: Mon-Fri: 9am-5pm, Sat: 12pm-2pm, Sun: none

Please check all opportunities you are interested in:

EDUCATION AND EMPLOYMENT | You are currently:

Education (highest):

High School/GED
College
Graduate School
Technical school

School

Field of Study:

Occupation:

Industry:

Employer:

Address:

Have you ever been employed by Project Hospitality?

Yes
No

REFERENCES: Please provide the names and phone numbers of TWO references. These should be teachers, employers, and other community members, not relatives.

Please include: Name, Telephone, and how long and what capacity has this person known you.

May we contact the above?

Yes
No

Emergency Contact (name, phone & relationship to you)

Name, Relationship, Phone

What is your primary language? Second language?

Special Skills:

Physical Restrictions:

I certify that the above answers are correct to the best of my knowledge. I understand that all application information will be kept confidential and is used solely for assignment purposes.

I agree

Volunteer Confidentiality and Fraternization Pledge: I am volunteering my time to work at Project Hospitality, Inc. I understand that in the course of my work I may learn certain facts about individuals who are employed by, volunteer for, or are being served by Project Hospitality that are of a highly personal and confidential nature. Examples of such information include, but are not limited to, health status, relations with family members, housing status, sexual orientation, finances, medical condition and treatment, employment status and other personal information. I understand that all such information must be treated with absolute confidentiality as required by. Public Health Law 27F; NYS DOH Regulation Part 50-4; Public Officers Law, Article A; and Project Hospitality’s policies and procedures. I agree not to disclose any confidential information to any person not affiliated with. Project Hospitality and authorized by Project Hospitality to have such information without the written consent of the individual to whom the information pertains. I also understand that Fraternization with clients is unacceptable. In general, Fraternization is deemed for our purposes as developing any relationships with clients, which interferes with the objective performance of our work. Dating between volunteers and clients is also strictly forbidden. If there is any doubt about a situation for possible fraternization, I will consult the supervisor in the area in which I am volunteering or the Volunteer Services Coordinator immediately. I understand that any breach of my obligation to strictly adhere to these policies regarding confidential information and fraternization may result in my immediate dismissal as a volunteer for Project Hospitality.

I agree