Volunteer/Internship Application

Volunteer Internship Application

Please apply by filling out the details below.

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ABOUT YOU

Name

First

Last

Street Address*

City/State*

Zip*

How long at this address?

Home Phone*

Email*

Cell Phone*

Date you are available for volunteerism

Internship period from*

Internship period to*

Notice

All volunteers/interns submit to a criminal background check, national sex offender public registry check, drug screen Mantoux (TB Skin Test). A motor vehicle check will be conducted on individuals for duties which require driving.

Have you ever been convicted of a crime that has not been expunged by a court?

Yes

Are you a registered as a convicted sex offender?

Yes

Are you 18 years of age or older?

Yes

If under 18 years of age, you will be required to submit a birt certificate or work permit as required by state or federal law.

Any friends or relatives presently employeed at TradeWinds?

How did you hear about TradeWinds?

CURRENT EMPLOYER

Name of current employer

Job title

Immediate Supervisor and Phone Number:

List any special skill(s) (Laungage, Computer, Technical, Trades)

Availability

Monday From

Tuesday From

Wednesday From

Thursday From

Friday From

Saturday From

Sunday From

Monday To

Tuesday To

Wednesday To

Thursday To

Friday To

Saturday To

Sunday To

how many hours per week are you available

Do you have any special scheduling requirments?

REFERENCES

Reference 1

Reference's name, occupation, and address

Number of years known

Phone number

Reference 2

Reference's name, occupation, and address

Number of years known

Phone number

Reference 2

Reference's name, occupation, and address

Number of years known

Phone number

CAREFULLY READ EACH STATEMENT BEFORE SIGNING AT THE BOTTOM

*TradeWinds is an Equal Opportunity & Affirmative Action employer. TradeWinds does not discriminate with regard to race, color, religion, gender, age, citizenship, national origin, disability, genetics, medical condition, sexual orientation, marital status, military status or any federal, state or local anti-discrimination laws. I certify that all of the information provided in this volunteer/internship application is true and complete to the best of my knowledge and I authorize investigation of all statements contained in this application, including a criminal background check, motor vehicle check and drug test, as applicable. I understand that any false or incomplete information may disqualify me from further consideration for this position and may result in the immediate termination of the relationship if discovered at a later date. I understand and acknowledge that unless otherwise defined by applicable law or written agreement with TradeWinds, any relationship with TradeWinds will be "at will." This means that I may resign at any time and you may terminate the relationship at any time, with or without cause and with or without advance notice. I authorize the investigation of any or all statements contained in the application and also authorize any person, school, current employer, past employers and other organizations to provide information concerning my previous employment and other relevant information that may be useful in making the decision to form a relationship with me. I release such persons and organizations from any legal liability in making such statements.*

I have read the above

Volunteer/Intern Signature:

Time

Volunteer/Intern Waiver, Release of Liability, and Hold Harmless Agreement

I have agreed to the services as a volunteer/intern at TradeWinds Services, Inc. This waiver, Release, and Hold Harmless Agreement covers all events and occurrences associated with this volunteer's/intern's activities.

By signing this Waiver, Release, Hold Harmless Agreement, I voluntary agree:

If I have concerns about my health or ability to participate in volunteer/intern activities, it is my responsibility to discuss my concerns with my physician before deciding to participate as a volunteer/intern at TradeWinds Services, Inc.

As a volunteer/intern, I am not an employee of TradeWinds Services, Inc. nor am I covered by worker's compensation or any other insurance policy through the agency.

To assume the risk that unexpected events may occur and result in loss, harm, injury, or illness to me or damage to my property while I am participating in or observing volunteer/intern activities or while I am traveling to or from the activity.

I hereby agree to indemnify and hold harmless TradeWinds Services, Inc. its sponsors, employees, volunteers, interns, affiliates, officers, agents, successors and assigns, subordinates, and any other persons connected to this event from any liability, specifically including negligence attributed to TradeWinds Services, Inc.

In the event that I require emergency medical treatment, I give my permission for evaluation, diagnoses, treatment, and/or medication in accordance with the standard medical practice by licensed medical personnel. I relieve TradeWinds Services, Inc. of all responsibility and consequences that may arise as a result of treatment. Further, I agree to accept any and all financial responsibility as a result of the performed treatment.

I enter into this waiver of my own free will, and no duress or promises have been made to me for purposes of inducing me to sign this document.

Printed or Typed Name of Volunteer/Intern

Signature of Volunteer/Intern

Date

Address of Volunteer/Intern

Emergency Contact

Primary Phone

Secondary Phone

If Volunteer/Intern is under the age of 18 years, Parent or Legal Guradrian must also sign:

Signature of Parent/Guardian

Date

I have discussed the impact and effect of this agreement with the above signed minor for whom I am the parent/legal guardian and they have expressed that they understand the same and wish to be bound by its terms. I further, specifically agree to be bound by this agreement in its entirety on my own behalf and on behalf of my child/legal ward.

TradeWinds Services, Inc. Consent To Conduct Criminal Background Check

CONFIDENTIAL RECORD

TradeWinds Services, Inc. conducts criminal background checks on all candidates for any position within or related to TradeWinds Services, Inc. A criminal conviction or pending criminal charge may be a factor in the decision to appoint a candidate to a position; however, may not be an absolute bar to employment with TradeWinds Services, Inc.

Completion of this form is a mandatory part of your application process. You must fill out this form accurately and completely. Applicants who fail to do so will be dismissed from further employment processing and those who are found to have provided false information will be terminated.

The information requested below is required to conduct a criminal history background check and will not be used for any other purpose. Discrimination on the basis of race, color, religion, gender, age, citizenship, national origin, disability, genetics, medical condition, sexual orientation, marital status, military status, or any other legally recognized status entitled to protection under applicable federal, state, or local anti- discrimination laws.

Position applied for:

Name

First

Last

Other names you have used:

Current Address

# of years at current address

Street Address

City

State

Zip

Country

Current Address

# of years at previous address

Street Address

City

State

Zip

Country

Current Address

# of years at current address

Street Address

City

State

Zip

Country

Confidential Record

Date of birth

City and state of birth

Drivers license number

Drivers license state issue

Gender

Race

Height

Weight

Eye Color

Have you ever been convicted of a crime that has not been expunged by a court? Failure to discolse a conviction for any felony will be considered an intentional omission.

Yes

Do you have any pending charges?

Yes

I consent to a criminal background check for purposes of employment with TradeWinds Services, Inc. The information I provided on this form is true and complete to the best of my knowledge. I understand that falsification or omission of information will result in dismissal from employment processing or immediate termination.

Untitled

Date

This field should be left blank

Volunteer Internship Application