Application for Volunteer Groups

Thank you for your interest in joining Merrick Community Services (MCS) as a volunteer group. MCS is an equal opportunity employer and we will not unlawfully discriminate on the basis of race, ethnicity, color, creed, religion, national origin, sex, age, marital status, sexual or affectional orientation, and status with regard to public assistance, membership or activity in a local commission or disability.

Please have the group leader/main contact person fill out the application below.

Name of Group *

Group Leader/Main Contact *

First Name Last Name

Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

Phone Number *

Area Code Phone Number

E-mail *

Employer

Birth Date (optional)

Month Day Year

The group leader/main contact person is responsible for making sure each group member has filled out the information below prior to volunteering.

Please direct your group members here to submit their information:

http://www.jotform.us/merrickcsstp/Group_Volunteer_ContactInfo

What date/dates is your group looking to volunteer? Please include time available during these dates.

How many hours are you able to volunteer?

Hours

Per

Does your group have any restrictions? (i.e. can't lift more than 20 pounds, must be sitting, cannot drive, etc.)

Are there any children in your group?

Yes No

How many people are in your group?

Is there a specific program your group would like to work with? Typically, volunteer groups will volunteer at our Food Shelf, or if it is in the spring or fall, we will encourage you to participate in the Spring/Fall lawn clean-up for Seniors. That is our greatest need. If it is around Christmas, volunteer groups may be able to assist with Holiday Share.

Emergency Services

Food Shelf Caring Tree (School supply collection)

Services for Senior Citizens

Meals on Wheels Delivery Spring/Fall lawn clean-up for Seniors

Office Support

One-time Ongoing

I understand that some volunteer positions at MCS require reference checks and criminal background checks. I authorize the investigation of all statements contained in this application. I also authorize MCS to contact listed references. I authorize any person, school, employer and organization named in this application form to provide MCS with relevant information and opinion that may be useful to the agency in making a volunteer placement decision, and I release such person and organizations from any legal liability in making such statements. I understand that acceptance as a MCS volunteer and assignment to a volunteer position is based on assessment by program staff and the availability of a suitable position for me. I also understand that submitting this application does not obligate me as a volunteer with MCS. I give MCS permission to take photos of me during this event for use in publications and advertising. I release MCS from liability in the event of injury while or during my volunteer activities.

I agree *

Yes

To fast track your application, please upload a photo of your drivers license so we can complete a required background check. Depending on your assignment other volunteers may also have to submit identification for a background check.

Application for Volunteer Groups

Hours and Availability

Areas of Interest

Application Submission