Individual Volunteer Profile

Similar documents
Conditional employee name (print) Food employee name (print) Address

Employee Illness Log

Annex 7 Model Forms, Guides, and Other Aids

The Society of St. Vincent de Paul. Riverwalk. San Marcos, TX

7. Pledge form B, for use if the Parish SVDP chooses to raise funds at the Parish Level by general Sponsorship (attachment 5)

JDRF Hampton Roads Youth Ambassador Program Description

Talisman Therapeutic Riding, Inc. PO Box 300, Grasonville, MD

Michigan Department of Agriculture. lf YES, Date qflonse!

Junior Volunteer Application

Young Ushers Program

Policies and Procedures Volunteer Opportunity Descriptions General Guidelines Frequently Asked Questions & Contact Information

JDRF Oklahoma. Youth Ambassador Program 2017 Promise Ball 20 th Anniversary. Information Packet

Welcome to the Cedar Grove-Belgium Fitness Center

EMPLOYEE SICK POLICY GUIDELINES

Latoya Thomas Volunteer Resources Coordinator

DIOCESE OF CORPUS CHRISTI

at our Wilmington Branch

Personal Training Information Packet

Waiver, Release and Hold Harmless Agreement Personal Training Services

Jumpstart, Fitness Assessment, & Body Composition

Baby-Sitting - $20 Per Day/Per Nanny (local clients) Less than 24 hours notice $30 Per Day/Per Nanny. Hotel Overnight Sitting - $35 per Day/Per Nanny

at our Greenville Branch

Exhibitor Prospectus. Kalahari Resort & Convention Center 1305 Kalahari Drive Wisconsin Dells, WI 53965

CONFERENCE ROOM AND FACILITIES POLICY

TRAINER: Read this page ahead of time to prepare for teaching the module.

DIOCESE OF CORPUS CHRISTI

Summer Youth Institute Packet

Facilitator Application CA Training

Volunteer Application

at our Raleigh Branch

Emergency Contact Name: Emergency Contact #:

Tomorrow s SMILES Program

P: F:

P: F: Session Information Sessions are held quarterly, registration is ongoing. Monday, Wednesday 2:00PM 3:00PM

Please complete the medical history section below so that we can be sure to respond to any

Presbyterian Night Shelter Volunteer Application

MAIL TO: TEC New Orleans CYO/Youth and Young Adult Ministry Office Archdiocese of New Orleans 2241 Mendez Street New Orleans, LA

IMPORTANT DATES AYBA 2018 Season

PENNSYLVANIA CERTIFICATION BOARD

Village of Orland Park Recreation Department. Adopt-A-Park and Path. Handbook

LIFEGUARDING CERTIFICATION CLASS

Fundraising Information Packet

Wellness Department. Non-Resident Pool Membership Packet. Page 1

Client Intake Form - Therapeutic Massage

2010 Sharing Hope Program for men

Please don t hesitate to call if you have any questions. I can be reached at (603)

2018/19 The Rock Youth Center Registration Packet. Instructions

July 11 th through July 25 th

Name: Last First Middle Initial. Address: Street City State Zip Gender: Male Female Phone: (H) (C)

P: F: balance. Some exercise equipment will be used such as treadmills, NuSteps and resistance devices.

Platinum Sponsor $15,000

Thursday, March 28 th 5:00 pm 10:00 pm Friday March 29 th & Saturday March 30 th 10:00 am 10:00 pm Sunday March 31 st 10:00 am 5:00 pm

Should you have questions or concerns, please contact the Program Supervisor at the location your child is registered.

(3) Had a past illness from an infectious agent specified under paragraph (A)(1) of this rule; or:

2013 Annual Symposium

Byron-Bergen Central. School District. Fitness Room. Gillam Grant Community Center Community Education Program

Kairos 79 November (Seniors) Kairos 80 February19-22 (Seniors)

Application to Livingston Robotics Club Season Part A: Student information. Name: (Student) Home Address:

CWA SPONSORED FUNCTION

Accommodations Request Severe Allergies Cover Sheet

FRIDAY, SEPTEMBER 15 REGISTER YOUR TEAM NOW AND BEGIN FUNDRAISING TO SUPPORT UNITED WAY AND WIN PRIZES!

Autism Society of Greater Orlando s 2018 Autism Walk & Family Fun Day **Annual Fundraising Event**

Criteria and Application for Men

(City, State, Zip Code)


ORGANIZATION INFORMATION

Substance Youth Winter Retreat. February 24-25, 2017 Burtrum, MN

Dear Prospective Volunteers,

SUMMER FRIDAYS on the E.D.G.E. REGISTRATION FORM

Hello, Fundraiser! All the best, Julie Lowe Ronald McDonald House Charities of Greater Washington, DC

Town of West Seneca Youth Engaged in Service New Volunteer Orientation Guide

Becoming a Peer-to-Peer Mentor

Waves of Opportunity. 31st Annual Conference. Exhibitor Prospectus. The Nurse Practitioner Association New York State

Participant Information Exercise Equivalent Chart Weekly Activity Log Participation Agreement Waiver and Indemnity Agreement

MEMBERSHIP APPLICATION

Please click going on the Shanty Town facebook event invite for timeline, tips and more information as it becomes available.

Invitation to Sponsor or Exhibit. Primary Care Focus Symposium, 18 th Annual. Friday-Sunday, July 12-14, 2019 The Ritz-Carlton, Naples, Florida

NAMI California Peer-to-Peer Mentor Training Application

Completed applications can be submitted either by mail or to:

STUDENT REGISTRATION FORM

GENERAL INFORMATION FOR VOLUNTEERS

Master Artist Workshop Series

Family Application: Nanny / Mother s Helper

Patient Registration. First Name: Last Name: Middle Initial: Address: City, State, Zip: First Name: Last Name: Middle Initial:

Oxford Parks & Recreation Department. Fit After 50 Workout Center. Membership Packet

Cable Splicer/Electrician Underground Task Specific Exercise Candidate Orientation Guide

Operation Screen Your Athlete Medical Questionnaire

Client Contact Information. Training Information

Participant Information Exercise Equivalent Chart Weekly Activity Log Participation Agreement Waiver and Indemnity Agreement

Personal Training New Client Packet Personal Training/Fit for Hire

Purpose: To inform all employees of the guidelines regarding the correct use of the Employee Gym.

Family Application: Nanny / Mother s Helper

Pedaling for Parkinson s Colorado What is Pedaling for Parkinson s?

Thank you for inquiring about our Shelly Aquatic Center at Brethren Village. We hope you will find the enclosed information helpful.

2016 Spring Meeting. Exhibitor Prospectus. March 11-13, 2016 DoubleTree by Hilton Hotel 1521 W. Pinhook Road Lafayette, LA

July 5th-7th, 2016 Thompson Rivers University, Kamloops

SCHEDULE. Tentative schedule for the weekend. Friday, March 29 th 4:30 6:30PM Check-in (Dinner on your own)

Community Education. City State Zip Code. Term (please circle one) Summer 20 Fall 20 Winter 20 Spring 20

Winter Meltdown Youth Pastor Checklist

Transcription:

Individual Volunteer Profile Please return completed forms to Jennifer Small at small@mdfoodbank.org, or by fax 410.742.0554, or mail to the Maryland Food Bank Eastern Shore, 28500 Owens Branch Road, Salisbury, MD 21801. (Please print clearly) Name Date Date of Birth (mm/dd/year) Mailing Address: Street City State Zip County E mail Home Phone Cell Phone Preferred Method of Contact E mail Home Phone Cell Phone Text Reason for Volunteering? (check all that apply) Contribute to community Meet new people Develop skills Explore career path Service Learning requirement name of school or program: How Did You Learn About Us Newsletter Website Volunteer Center Social Media Friend Employer Organization Other: Work Interest (check all that apply) Warehouse Duties Office support, including data entry Special Events Farm to Food Bank Program Gleaning Assist with Volunteer Recruitment Hours Available Warehouse Weekdays: Morning (8:30am 11:30am) Afternoon (12:00pm 2:30pm) Wednesdays (3:00pm 5:00pm) 2nd Saturdays (8:00am 11:30am)

Farm to Food Bank Program Weekdays: Morning (8:00am 12:00am) Week Nights: Monday Thursday (6:00pm Dark) Sunday Evening (6:00pm Dark) Schedule Preference Once or twice a month Once or twice a week Everyday Other: Available on Short Notice? Yes No Access to Truck or Van? Yes No Emergency Information Name Relationship Phone (home) (work) ******PLEASE READ****** For the warehouse, please do not just show up. An accurate count of volunteers is needed in order to assign work projects. Groups/Individuals not registered cannot be accommodated. Donated food or product should never be removed from the warehouse. All donations are the property of the Maryland Food Bank. No open toe shoes are allowed in the warehouse. Please wear tennis shoes or boots that cover the entire foot. For Farm to Food Volunteers: We strongly encourage you to inform the Farm to Food Bank Coordinator if you will be able to attend the gleaning. If there is a low response, the gleaning may be cancelled. Dress according to the weather and gleaning activity. Bring a bottle of water / snacks. Should a gleaning be cancelled due to weather, every effort will be made to contact those whom we know were attending.

Group Volunteer Profile Please return completed forms to Jennifer Small at small@mdfoodbank.org, or by fax 410.742.0554, or mail to the Maryland Food Bank Eastern Shore, 28500 Owens Branch Road, Salisbury, MD 21801. (Please print clearly) Group Name Date Group Leader Cell Phone Group Affiliation / Employer Mailing Address: Street City State Zip County E mail Home Phone Cell Phone Preferred Method of Contact: (please check one) E mail Home Phone Cell Phone Text How many in your group? 1 11 12 15 15 20 over 20 Reason for Volunteering? (check all that apply) Contribute to community Meet new people Develop skills Explore career path Service Learning requirement name of school or program: How Did You Learn About Us Newsletter Website Volunteer Center Social Media Friend Employer Organization Other: Work Interest (check all that apply) Warehouse Duties Office support, including data entry Special Events Farm to Food Bank Program Gleaning Assist with Volunteer Recruitment

Hours Available Warehouse Weekdays: Morning (8:30am 11:30am) Afternoon (12:00pm 2:30pm) Wednesdays (3:00pm 5:00pm) 2nd Saturdays (8:00am 11:30am) Farm to Food Bank Program Weekdays: Morning (8:00am 12:00am) Week Nights: Monday Thursday (6:00pm Dark) Sunday Evening (6:00pm Dark) Schedule Preference Once or twice a month Once or twice a week Everyday Other: Available on Short Notice? Yes No Emergency Information Name Relationship Phone (home) (work) ******PLEASE READ****** For the warehouse, please do not just show up. An accurate count of volunteers is needed in order to assign work projects. Groups/Individuals not registered cannot be accommodated. Donated food or product should never be removed from the warehouse. All donations are the property of the Maryland Food Bank. No open toe shoes are allowed in the warehouse. Please wear tennis shoes or boots that cover the entire foot. For Farm to Food Volunteers: We strongly encourage you to inform the Farm to Food Bank Coordinator if you will be able to attend the gleaning. If there is a low response, the gleaning may be cancelled. Dress according to the weather and gleaning activity. Bring a bottle of water / snacks. Should a gleaning be cancelled due to weather, every effort will be made to contact those whom we know were attending.

Maryland Food Bank volunteers work at our distribution center sorting and packing food and product to feed hungry Marylanders. This activity may require lifting of up to 25 lbs. WAIVER AND RELEASE OF LIABILITY I,, the undersigned hereby acknowledge my receipt of permission to volunteer for the Maryland Food Bank. I also acknowledge my understanding that my service as a volunteer on Maryland Food Bank property located at 28500 Owens Branch Road Salisbury MD 21801 may expose me to various risks of injury and/or illness. I do hereby agree and understand that I assume these risks and I agree not to hold the Maryland Food Bank, its agents, employees or volunteers liable for any such injury and/or illness. I understand that this Waiver and Release of Liability extends to and applies to any personal injuries, injurious results, damages or losses I may experience or sustain while engaged in training for volunteer service or while engaged in serving as a volunteer for the Maryland Food Bank. I covenant not to file suit or initiate any claim procedure with respect to any personal injuries, property damages or losses I may experience or sustain arising directly or indirectly out of my activities. Name of Volunteer (please print) Date Signature of Volunteer PARENT/GUARDIAN WAIVER FOR MINORS (under 18 years old) The undersigned parent/guardian does hereby represent that he/she is, in fact, acting in such capacity, has consented to his/her child or ward s participation in the activity or event and has agreed individually and on behalf of the child or ward, to the terms of the Waiver and Release of Liability set forth above. The undersigned parent/guardian further agrees to save and hold harmless and indemnify each and all of the parties referred to above from all liability, loss, cost, claim, or damage whatsoever which may be imposed upon said parties because of any defect in or lack of such capacity to so act and release said parties on behalf of the minor and the parent/guardian. Name of Minor (please print) Signature of Parent/Guardian

Volunteer Health Guidelines Hand- washing o Warehouse volunteers must wash their hands before going to the warehouse. o Kitchen volunteers must wash their hands in the kitchen. Volunteer Water Supply o Open water bottles, drinks, and food are not allowed in the warehouse. o A supply of water for volunteers is available in the cooler by the double warehouse doors. Water may only be consumed in the break room area. Recalls o Daily updates on recalled foods unsafe for consumption are now available and will be posted in the salvage sort room. Expiration Dates o Non- perishable items are generally shelf stable and do not need to be checked for dates. o Items to be checked are as follows:! Baby formula/food! Mayonnaise (good for 3-6 months after the date)! Baking mixes containing baking powder Overflow Bins MUST be elevated off the ground o Whether in or out of a box, no food may be on the ground at any time. Non- food Changes o Cleaning supplies! No cleaning chemicals can be stored near food; this includes candles, air fresheners, bug spray, motor oil, etc.! Volunteers must gather and place cleaning supplies on a separate empty pallet. o Paper! Bulk items too large for boxes should be placed to the side.! Paper outside of its wrapping may NOT be packed. o Baby! Diaper rash creams, baby sunscreen, or any chemicals may NOT be packed.! Any creams or chemicals MUST go in Health & Beauty. o Pets! Pet products must have a slip sheet between product and the pallet.! Large bags and banana- boxed product must be on separate pallets.

Volunteer Health Policy Agreement Exclusion or Restriction from Volunteering If you have any of the symptoms or illnesses listed below, you may be excluded or restricted from volunteer work at the Maryland Food Bank. *If you are excluded, you will not be able to be at the Maryland Food Bank. ** If you are restricted, you will be able to come to the Maryland Food Bank, but your duties may be limited. Reporting: Symptoms of Illness I agree to report to MFB when I have: 1. Sore throat with fever 2. Jaundice (yellowing of the skin and/or eyes) 3. Diarrhea and/or vomiting 4. Infected cuts or wounds, or lesions containing pus on the hand, wrist, or an exposed body part (such as boils and infected wounds, however small). Reporting: Diagnosed Illnesses I agree to report the MFB when I have: 1. Norovirus 2. Salmonella Typhi (typhoid fever) 3. Shigella spp. infection 4. E. coli infection (Escherichia coli O157:H7 or other EHEC/STEC infection) 5. Hepatitis A Reporting: Exposure of Illness I agree to report to MFB when I have been exposed to any of the illnesses listed above through: 1. An outbreak of Norovirus, typhoid fever, Shigella spp. Infection, E. coli infection, or Hepatitis A. 2. A household member with Norovirus, typhoid fever, Shigella spp. Infection, E. coli infection, or Hepatitis A. 3. A household member attending or working in a setting with an outbreak of Norovirus, typhoid fever, Shigella spp. Infection, E. coli infection, or Hepatitis A. Returning to Volunteering If you are excluded from volunteering for having diarrhea and/or vomiting, you will not be able to return to the food bank until more than 24 hours have passed since your last symptoms of diarrhea and/or vomiting. If you are excluded from volunteering for exhibiting symptoms of a sore throat with fever or for having jaundice, Norovirus, typhoid fever, Shigella spp. Infection, E. coli infection, and/or Hepatitis A, you will not be able to return until the Health Department or a health practitioner approval is granted. Agreement I understand that I must: 1. Report when I have or I have been exposed to any of the symptoms or illnesses listed above; and 2. Comply with restrictions and/or exclusions that are given to me. I understand that if I do not comply, I may not be able to return as a volunteer to the Maryland Food Bank. Volunteer Name (please print) Signature of Volunteer Date

I, a Volunteer of the Maryland Food Bank, understand that no product is to be removed from the warehouse or building premises of the Maryland Food Bank Eastern Shore Branch, without the authorization of the Managing Director and/or Operations Manager. I understand that by not adhering to this policy, I will be immediately dismissed from the volunteer program. Although the work of our volunteers is vital to our food distribution, the branch will adhere to company policies and procedures which state theft will not be tolerated. Volunteer Signature: Date: Management Signature: Date: