A Shelter for Women and Their Dependents
Intern/Volunteer Application for La Posada Home
Today’s Date ___/___/______
Contact Information
Name
Street Address
City, State, Zip Code
Phone Number
Other phone #
E-mail Address
Intern/Volunteer Completion and Date
Hours Needed _______hrs from (UTEP, UOP, EPCC, other) _____________________
By ____/____/_____
Availability
During which days and hours are you available for volunteer assignments?
Mon.
Tues.
Wed.
Thurs.
Fri.
Sat.
Sun.
Interests
Tell us in which areas you are interested in volunteering.
___Internship
Field of Study(ex. Social Work, Human Services, Education, etc)_____________
Graduation Date___/___/_____ Degree(ex. Bachelor’s, Master’s, PhD, etc.)________________
___Tutoring
___Fundraising/Phone Bank/Deliveries
___Administration/Office/Clerical
___ Events
___Casework Observation & Assistance
___Maintenance (Front/Backyard Work
Special Skills or Qualifications
Summarize special skills and qualifications you have acquired from employment,
previous volunteer work, or through other activities, including hobbies or sports.
Office Use only----------Start Date
/
/
----- Passed BC yes/no---- Completed yes/no
A Shelter for Women and Their Dependents
Previous Volunteer Experience
Summarize your previous volunteer experience
Person to Notify in Case of Emergency
Name
Street Address
City, State, Zip Code
Home Phone
Work Phone
E-Mail Address
Agreement and Signature
By submitting this application, I affirm that the facts set forth in it are true and
complete. I understand that if I am accepted as a volunteer, any false statements,
omissions, or other misrepresentations made by me on this application may result in
my immediate dismissal. If under 18 years old a parent/guardian signature is
required.
Name (printed)
Name (Parent/Guardian)
Signature
Date
Signature
/
/2011
Our policy
It is policy of this organization to provide equal opportunities without regard to
race, color, religions, national origin, gender, sexual preference, age, or disability.
***Thank you for your interest in La Posada Home, and completing this application
form for us.
A Shelter for Women and Their Dependents
Fraternization Policy
As stated on the Intern and Volunteer Agreement, La Posada Home staff expects
volunteers to demonstrate the responsibility, respect, and confidentiality of the
residents. At no point, will La Posada Home accept any fraternization between the
volunteer and the residents.
*Examples include, giving away contact information to residents, meeting them
somewhere else other than the Posada Home, making future plans for get-togethers,
etc.
*If for any reason there is any suspicion of fraternization between the volunteer and a
resident, the volunteer will have a meeting with the Volunteer Coordinator or might
be asked to not come back. This will be considered a Failure or Incompletion and it
will be reported to volunteer’s coordinator.
*Please keep in mind that we are extremely grateful for your interest in our shelter.
Our best intentions are for the success of our residents and YOUR success of
completion of your hours with an experience of participating as a good community
citizen by bettering the lives of others in need.
*By signing the applicant understands the Fraternization Policy at La Posada Home.
_________________________________________
Signature
Date
A Shelter for Women and Their Dependents
Confidentiality Agreement
1. I agree that any written information that has been disclosed to me as
“confidential” during my term will remain in the strictest confidence.
2. I agree that all “confidential” material that has been given to me as a result of
my membership in the board or committee will be maintained, and when necessary
disposed of in a secure and confidential manner.
3. I agree not to publicize and of the confidential aspects of my work rally or by
written word or any other medium of communication.
4. I agree to exercise due care to ensure that any information that I may give to
others in the course of my term will be given only to persons I believe are entitled to
receive such information.
5. I confirm that I have read the above statements and agree with them. I will
adhere to all confidential requirements contained in this agreement or as otherwise
directed to me in writing by La Posada Home, Inc. during my term.
Signed at the La Posada Home, Inc. this day of
Name: _______________________
Date: _____/______/20____
A Shelter for Women and Their Dependents
Code of Ethics
La Posada Home, Inc. expects all Members to adhere to the Code of Ethics during
their term of membership.
Confidentiality Agreement
All Members will be expected to enter into a Confidentiality Agreement.
Personal Property
Members are responsible for the safety and security of all their own personal property
and possessions.
Identification
Members will use official identification provided by the La Posada Home, Inc.
Code of Ethics
As a volunteer appointed by La Posada Home, Inc. I agree to adhere to the Code of
Ethics during my term as follows:
I pledge to provide my time and as a volunteer in the best interest for the best interest
for the La Posada home, Inc.
I pledge to place honesty and integrity above all else and to promote the La Posada
Home, Inc.
I pledge to comply with all written policies and guidelines that have been provided
relevant to the board or committee on which I will serve.
I pledge to maintain an equitable, honorable and cooperative relationship with La
Posada Home, Inc. in matters relating to the board or committee activities.
5. I pledge that my position as a volunteer will not be used to grant special privileges
to any person or group, and I will avoid all other conflicts of interest which may arise
from my position as a volunteer.
I pledge that my position as a volunteer will not be used for business or personal
benefit or gain.
Signed at the La Posada Home, Inc. this day of
Date:______/______/20____
Name:_____________________________
Signature:__________________________
A Shelter for Women and Their Dependents
Intern and Volunteer Agreement
Welcome to La Posada Home, Inc. We are pleased that you have decided to
volunteer your time with us as part of a partnership
between________________(University, College), and _________________(Student),
and La Posada. Helping our community can be an extremely rewarding and
invaluable learning experience. There are a few points that you need to read and be
aware of before making the commitment to work at La Posada.
Program Outline
1. It is required that volunteers participate in a training session prior to the
initiation of the volunteer’s tenure at the shelter.
2. The natures of the shelter’s programs are very serious. Families have come
from difficult situations to seek our assistance. While working at La Posada,
the staff expects volunteers to demonstrate the responsibility, respect, and
confidentiality that the position requires.
3. While working at La Posada, volunteers will be assigned a specific task or
project so that tangible or measurable progress can be assessed. This is done to
ensure that the volunteer and the shelter’s time and resources are used in an
efficient and productive manner.
Attendance
1. The staff asks that you provide a schedule of the hours you are available and
days you are willing to work. The best staff is willing to accommodate almost
any schedule, but expect volunteers to comply with the schedule once they
have agreed to it.
2. Should there be any circumstances where the volunteer will be absent or late,
we ask that you please be considerate and call with enough time BEFORE our
scheduled volunteer time.
3. Should the volunteer not give advanced notice before an absence or excessive
tardiness, their placement at the shelter will be suspended until an evaluation
meeting is held between the volunteer and the executive director.
We want to thank you for your desire to work with us. If you have any questions or
need clarification, please do not hesitate to ask.
Both signing parties have read and understood the terms of the Volunteer Agreement.
________________________
Volunteer
_______________________
La Posada Home, Inc. Staff
__________________
Date
A Shelter for Women and Their Dependents
Volunteering at La Posada Home, Inc.
Policies and guidelines for the success and protection of Volunteers and La Posada
Home, Inc.
Opportunities
Volunteering at La Posada Home, Inc. offers opportunities for:
La Posada Home, Inc. and volunteers to collaborate.
La Posada Home, Inc. to benefit from the value of voluntary and community service.
Volunteers to develop civic pride in the giving of their time and expertise.
Guiding Principles
Participation
La Posada Home, Inc. encourages citizens to volunteer and contribute their expertise
to improve the welfare of the clients of the Home.
Qualified and Dedicated People
La Posada Home, Inc. invites as volunteers, citizens with skills and qualifications to
share both their time and talent freely for the benefit of the clients of La Posada
Home…
Recognized Contributions
La Posada Home, Inc. appreciates commitment and time given by their Volunteers
and recognizes their valuable contributions and the spirit in which they are given.
Definition and Categories
Volunteer Definition
A person who, of their own free will, provides service to the Home while under the
general supervision of La Posada Home while under the general supervision of La
Posada Home, Inc. or as a member of a board or committee appointed by La Posada
Home, Inc. without compensation or other consideration.
Categories
Individual volunteers
Volunteer groups
Performance
The volunteer will be encouraged to complete their duties and/or attend meetings on
a regular basis, for which the volunteer freely gives their time and expertise to the
Home without financial compensation. The volunteer will be encouraged to
participate in additional duties or committee work where the volunteer may have
special interests and qualifications.