Volunteer Sign In Form

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Volunteer First Contact Form

Email Address*

First Name*

Last Name*

Reachable Phone Number*

Date of Birth*

Address, line 1

City

State

Zip Code

Emergency Contacts

Emergency Contact Name*

Emergency Contact Phone*

Emergency Contact Relationship

Interest and Availability

Are you volunteering as an individual?*

Yes No

Are you volunteering with a group?*

True False

Group Volunteer Name

If with a group, are you also interested on your own?

Yes No

Please indicate the types of activities in which you might like to participate:

Volunteer Activity: Animal Care

Yes No

Volunteer Activity: Gardening

Yes No

Volunteer Activity: Fundraising/Events

Yes No

Volunteer Activity: Education

Yes No

Volunteer Activity: Marketing

Yes No

Volunteer Activity: Other

True False

Volunteer Activity: Office Help

Yes No

Volunteer Activity: Farm Maintenance

Yes No

Do you have any special skills or hobbies you would like to lend to Auerfarm?

Court and Community Service Information (Required)

Are you completing a specific number of community service hour for:

School Youth Group Religious Purposes Court Mandate Other

Name of School/Youth Group/Religious Organization

If so, how many hours must you complete?

By what date?

Background Information

Profession

Business Degree

Past or present Volunteer Jobs

Want to help even more?

Many companies and civic organizations match gifts of time and/or money and many grantors are interested in donating to organizations that their employees, retirees, or members are involved.

Organizations of which you are an employee, retiree or member

To your knowledge, do any of these organizations provide matching gifts? Which ones?

Statement of Confidentiality (Required)

I understand that the nature of my volunteer position may require, in certain situations, i.e. client names, specific circumstances related to clients, and meeting and/or communication directly with clients. Therefore, I hereby state that all names, facts, paperwork and circumstances of my volunteering shall be strictly confidential in regard to any person(s) or entity outside of Auerfarm.

I also recognize that there shall be no sharing of information between Auerfarm and other organizations, unless approved by a staff member of Auerfarm.

In addition, I also understand that volunteers do not make policy decisions. Volunteers work under the supervision of Auerfarm management and administration; supervisors may vary depending on the project. Suggestions are always welcome and may be submitted to Isabel Volpe, Volunteer Coordinator. Volunteers are asked to call ahead in a timely fashion if you cannot work at the previously scheduled time. The only exception to not giving notice is in time of emergency.

Volunteer Code of Ethics (Required)

As a volunteer of Auerfarm, I pledge to:

Respect

Treat others with respective in all circumstances and in spite of any differences; demonstrate consideration and compassion for people, animals and plants; use good judgment in honoring the authority of staff members and volunteer leaders

Safety

Prioritize safety in all volunteer activities; adhere to farm policies and procedures discussed during training; use equipment and supplies appropriately; report all injuries immediately to a staff person

Integrity and Self-Discipline

Perform all tasks diligently and to the best of my abilities; recognize the value in my work and put in effort accordingly; be honest about my needs

Communication

Recognize that there are many methods of communication, including verbal and non-verbal; be conscientious towards the needs of others; express my own concerns and opinions as long as they are not harmful to others; ask for help when needed

Commitment

Recognize that commitment comes from my own motivation and values; remember why I am committed to helping improve Auerfarm Welfare
Value my role as a volunteer of the organization; strive to further Auerfarm’s mission

Your signature below attests to the above statement:

Confidentiality Ethics Statement Printed Name*

Confidentiality Ethics Statement Signature*

Confidentiality Ethics Statement Date*

RELEASE OF LIABILITY

(Required)

I acknowledge that I am of lawful age and that I have volunteered to help at Auerfarm, 158 Auer Farm Rd, Bloomfield CT 06002. I acknowledge that I receive no compensation from Auerfarm. I acknowledge that this work will involve hard work, which may include bending, stooping, reaching, kneeling, lifting, using hand tools, using motorized tools, carrying and other physically challenging tasks, and I certify and agree that I am in good health and am physically able to perform such work. I acknowledge that my volunteer work may involve risk of injury from such work and I agree that I am helping Auerfarm at my own risk.

I agree that, while helping at Auerfarm, I will:

Observe all safety requirements of Auerfarm, where volunteer work is conducted, and
Use my best judgment and common sense to avoid injury or damage to myself, all other persons volunteering for Auerfarm, all persons on the premises where volunteer work is being conducted, all property.

I acknowledge that Auerfarm is allowing me to participate in this volunteer work in reliance upon the statements made in the Release and upon the release of possible claims that I am providing in the Release. Accordingly, I do hereby, for myself, heirs, executors and administrators, release, acquit, and forever discharge Auerfarm, and the property owners where the volunteer work is conducted and their respective heirs, executors, administrators, successors and assigns, of and from all, and all manner of actions, causes of actions, suit controversies, damages, judgments, and other liabilities, claims and demands of any nature whatsoever whether in law or equity, resulting from my volunteer services for Auerfarm

I understand that this release is intended to prevent any and all future legal action or claims which I might have against Auerfarm arising out of my involvement in volunteer work, including travel to and from the volunteer site.

I grant full permission to Auerfarm to use any photographs, film, video, or audiotapes of me performing volunteer work for any purpose Auerfarm deems appropriate.*

Yes No

Liability Release Printed Name*

Liability Release Signature*

Liability Release Signature Date*

*If the volunteer is under age 18, a parent or legal guardian must sign for the volunteer and accept responsibility for his/her supervision.

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