Volunteer Application

BOSTON PRAISE RADIO AND TV

Volunteer Application and Agreement Form

(PRINT OUT THE APPLICATION AND E-MAIL IT TO [email protected]))

Last Name: ____________________________ First Name:_________________________ Date:____________
*Name of Parent or
Guardian if under 18 years:_______________________________________
*If volunteer is under 18 years, the parent or guardian must also complete a volunteer application and agreement form.

Address: _______________________________________ Tele:______________(H);_______________(O)

_______________________________________ Cell:_______________ Fax:_______________

_______________________________________ EMAIL:_______________________________

Company or Volunteer Group Name:___________________________________________________

Date of Birth: _____________________ Driver’s License No.___________________________
Emergency
Contact: _________________________________________________________________
(Name) (Tele.No.; Indicate Home, Work or Cell) (Relationship)

Do you have any friends/family members who are employed or volunteer here? _____Yes _____No

When are you available to volunteer (specify hours of availability)?

Monday ________ Tuesday _______ Wednesday _______ Thursday _______ Friday ________

Saturday________ Sunday _______ Holidays only_______

Types of volunteer work you think you’d be most comfortable with:

___Operating the board

___Operating the Camera

___Cleaning the studio

___Editing the Broadcast

___Helping at a group home
List Your Past Volunteer Experiences:

Organization:____________________ Duties:______________________ Mo/Yr. to Mo./Yr._________

Organization:____________________ Duties:______________________ Mo/Yr. to Mo./Yr._________

Have you ever been adjudged civilly or criminally liable for sexual abuse ? No___ Yes___; Have you been convicted of a crime? No___ Yes___ If yes, please describe:

BACKGROUND CHECK: Enable requires volunteers working with individual consumers to submit to a background check. Criminal conviction does not necessarily bar an applicant from volunteering. The nature of the offense will be taken into consideration before a decision is made. There is no fee on the part of the volunteer for the background check. Screening must be completed before volunteers begin working with consumers.

_____I agree to have a background check.

REFERENCES: List two people, not related to you who have knowledge of your qualifications.
Mailing
Name:_________________________________ Address:___________________________

Tele. No.:_______________________ __________________________________________
Mailing
Name:_________________________________ Address:___________________________

Tele. No.:_______________________ __________________________________________

I need the following accommodation(s) to work as a volunteer:___________________________

As a volunteer at Boston Praise Radio and TV I agree to abide by all applicable rules and regulations of the agency. I understand that I will receive no monetary benefits in return for my volunteer service and that Boston Praise Radio and TV may terminate this agreement at any time without prior notice for any reason. I hereby authorize Boston Praise Radio and TV to check my references, and I understand that a criminal background check is required.

I certify that my answers on this application are true and complete and that I have not knowingly withheld any information that might, if disclosed, affect my application unfavorably. I understand that any misrepresentation or omission of facts on this application could be cause for rejection of this application or dismissal.

I understand that after I submit my application, it will be reviewed and my eligibility for volunteer work will be determined. I agree to an interview with the on site station managers, office assistants and on site orientation to perform my volunteer role.

I hereby Release and Waive liability against Boston Praise radio and TV, a non-profit corporation, its directors, officers, employees and agents, its successors and assigns, for any injuries or illness that I myself or my dependent may suffer in connection with any volunteer work for Boston Praise Radio and TV . Further, I agree that Boston Praise Radio and TV is not liable for any damage to my property or my dependent’s property resulting from volunteer work for Boston Praise Radio and TV. I agree that this release is as broad and inclusive as permitted by the laws of the State of Massachusetts.

Volunteer Signature:_________________________________ Date:_________________________

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