Volunteer Application

For the

Big Rivers Chapter of the American Red Cross

 

Proudly serving Daviess, Hancock and Mclean Counties

 

Thank you for your interest in the American Red Cross.  In order to have your application processed, you must thoroughly answer all questions on the application form.  Applications filled out incompletely will slow down the application process so please complete full application, mail back or drop off  your application to:

Big Rivers Chapter

416 West Third Street, #1B

Owensboro, KY  42301

Once your application is received, our Volunteer Services Co-ordinator will contact you to set up a time to interview you!  While we encourage you to attach a resume, please note that a resume will not substitute for completing any portion of this application.  All information will be treated confidentially. 

 

American Red Cross considers applicants for all volunteer positions without regard to race, color, religion, sex, age, national origin, disabled or veteran status, or other legally protected status.

 

For more information on the Big Rivers Chapter please call or visit:

www.bigriversredcross.org

 

 

 

THE MISSION OF THE

AMERICAN RED CROSS

 

The American Red Cross is a humanitarian organization, led by volunteers, that provides relief to victims of disaster and helps people prevent, prepare for and respond to emergencies.  It does this through services that are consistent with the congressional charter and the fundamental principles of the International Red Cross and the Red Crescent Movement

 

 

The American Red Cross Values

Affirming our commitment to the Fundamental Principles of the International Red Cross and Red Crescent Movement, we pledge ourselves to these Values:

 

HUMANITARIANISM

We exist to serve others in need, independently and without discrimination, providing relief for victims of disasters and helping people prevent, prepare for, and respond to emergencies. 

STEWARDSHIP

We act responsibly, effectively, and efficiently with resources entrusted to us, always seeking to improve. 

HELPING OTHERS

We are attentive and responsive to those we serve, always listening to their needs and looking for ways to serve through existing or new initiatives. 

RESPECT

We acknowledge, respect, and support the rights and diversity of each person in our organization and in the communities we serve. 

VOLUNTARY SPIRIT

We, as a family of donors, volunteers, and staff, search for ways to provide hope to those we serve while demonstrating compassion, generosity, and appreciation. 

CONTINUOUS LEARNING

We seek, collectively and individually, to identify, obtain, and maintain competencies and the awareness required for exceptional service. 

INTEGRITY

We act with honesty, demonstrate courage and accountability under pressure

 
 

 


 

 

Volunteer Application

                                                                                                       

General Information

Last

First

Middle Initial

 

    

 

 Street Address

City

State

Zip Code

     

   

     

    

 Home Phone

Work Phone

Cell Phone

(     )      

 (          )     

(          )       

Email address

Emergency contact    Name

Phone Number

(        )

 Have you previously used any other names besides what is provided above?    No      Yes    If yes, please specify below:

 

   

 Are you over 18 years old?   ____ No      Yes

Red Cross Affiliation

 Are you now or have you ever been employed by the American Red Cross?  ____ No     ____Yes

 If yes, please list the location, title, department, and dates below:

     

Are you now or have you ever served as a Red Cross volunteer staff member?   No     ____ Yes

 If yes, please list location, title, department, and dates below:

 

 

Have you ever held any Red Cross certification (e.g., Health & Safety instructor,  DSHR member)? 

If yes, please list below :

 

     

 

 

Record of Conviction and Revocations

 Have you ever been convicted of a crime other than a minor traffic offense (including during Military Service)?

   No      Yes   If yes, explain:

  

Are you licensed to operate a motor vehicle? ____  No     Yes   If yes, which state?       Drivers License Number: _____________

Has your license to operate a motor vehicle ever been revoked?  No      Yes   If yes, please explain:

     

Have you ever been bonded?  No      Yes

 

Has your bonding ever been revoked?   No      Yes    If yes, please explain below

 

     

Have any of your Red Cross certifications ever been revoked?  No      Yes    If yes, please explain below

     
             

 
 

Experience: (Include both  paid and volunteer work experience, beginning with most recent) 

Organization Name

Address

City

State

Zip Code

    

     

     

     

     

 Telephone No

Your Title

Department

 (          )      

  

 

 Beginning Date

Ending Date

Final Salary

Supervisor's Name & Title

 

     

    

     

 If you are still employed, may we contact your employer?  Yes      No

 Summary of duties:

 

 Reason for leaving:

 

 Organization Name

Address

City

State

Zip Code

  

  

    

     

     

 Telephone No.

Your Title

Department

 (          )     

     

     

 Beginning Date

Ending Date

Final Salary

Supervisor's Name & Title

    

     

     

     

 Summary of duties:

 Reason for leaving:

     

 Organization Name

Address

City

State

Zip Code

     

    

     

     

     

 Telephone No.

Your Title

Department

   (          )     

  

     

 Beginning Date

Ending Date

Final Salary

Supervisor's Name & Title

 

    

   

 Summary of duties:

   

 Reason for leaving:

    

If you wish to describe additional work experience, attach the above information for each position on a separate piece of paper.

Education and Training

 High School Name

City

State

Diploma/Equivalent?

 

     

     

     

Yes      No

 

 College and/or Technical School Name

City

State

Degree?

 

     

     

     

Yes     ____  No

 

 Major

Degree Earned

If degree not earned, years completed:

 

     

    

 1      2    

 3      4

 

 Other Training or Degrees School Name

City

State

 

   

     

     

 

 Major

Degree Earned

 

    

    

 

Professional Licenses

 Title

No.

State

Expiration Date

 

     

    

   

    

 

 Title

No.

State

Expiration Date

 

 

     

   

   

 

Skills

 Second Languages (including Sign Language):

Written                           --- Fluency ---                       Spoken

                                                                                      
____________________       Exellent   ___

Good ___

Fair

 ___

Poor

 ___     Excellent ___ Good  ___ Fair___  Poor ___

 
 

Volunteer Opportunities: Check activities which interest you or skills you possess

Board Leadership

□        Board Member

□        Armed Forces Chair

□        Audit Chair

□        Disaster Services Chair

□        Disaster Health Services Chair

□        Finance Chair

□        Fund Development Chair

□        Health and Safety Chair

□        Building & Property Chair

□        Human Resources Chair

□        International Services Chair

□        Governance Chair

□        Preparedness Chair

□        Recognition Chair

□        Recruitment Chair

□        Service Delivery Chair

□        Strategic Planning Chair

□        Chair of Volunteers

□        Youth Services Chair

 

Military Services

□        Get to Know Us Before You Need Us

□        Armed Forces Emergency Services Vol. Coordinator

 

International Services

□        International Humanitarian Law Team Leader

□        International Social Services

       Caseworker

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

                                                          

 

Communication & Marketing

□        Community Ambassador

□        Community Events Coordinator

□        Feature Story Writer

□        Health/Safety PR Assist

□        Marketing Support

□        Volunteer Newsletter Coordinator

□        Orientation Presenter

□        Photographer

□        Public Relations Assistant

□        Public Affairs Chair

□        Red Cross Ambassador

□        Website Technician

 

Community Services

□        Emergency Translator

□        Language Bank Caseworker

 

Financial Development

□        Donor Acknowledgement

        Assistant

□        Grant Database Assistant

□        Grant Writer

□        Financial Development Special Events

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Community Disaster Education

□    After the Fire Safety Ed.

□    Bilingual Disaster Ed. Presenter

□    Disaster Hispanic Liaison

□    Community Disaster Ed. Presenter

□    Community Disaster Ed. Coordinator

 

Health & Safety

□    Health & Safety Instructor

□    First Aid Station Manager

□    Health Fair Coordinator

□    Health & Safety Scheduler

□    Health & Safety Presenter (Youth Programs)

□    HIV/AIDS Instructor

□    Instructor Aide

□    Equipment Guru

 

Disaster Services Human Resources System (DSHR)

□    Community Service

□    Individual Client Services

□    Partner Services

□    Staff Services

□    Material Support Services

□    Information Management Support Services

□    Organizational Support Services

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Miscellaneous

□        Executive Clerical Support

□        Clerical Support

□        Facilitator, Volunteer & Paid Staff Orientation

□        Historian

□        Transportation Service Fleet Maintenance

 

Youth

 

□        Community Disaster Ed. Presenter for Youth Audiences

□        Community Visibility/Measles Initiative

□        Disaster Response & Special Projects

□        Masters of Disaster Outreach Intern

□        Office Assistant

 

Disaster Action Team

 

□    Disaster Action Team Captain (DAT)

□    Disaster Action Team Coordinator

□    Damage Assessment

□    Disaster Action Team Mbr.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Availability:                            Long Term                               Short Term

 

 Monday

 Tuesday

 Wednesday

 Thursday

 Friday

 Saturday

 Sunday

 

 

 

 

 

 

 

 

 

 

 

 

 

Have you ever been discharged or asked to resign from a job or volunteer position?   No      Yes     If yes, explain:

 

     

 

 

I hereby certify that the facts set forth in this employment application are true and complete to the best of my knowledge.  I understand that false statements of any kind or omission of facts called for on this application are a basis for dismissal as a volunteer regardless when they are discovered.  I understand that I am not applying for employment with the American Red Cross, but rather a volunteer position which can be terminated at any time by me or the American Red Cross.

 

 

 

Signature of Applicant:

 

Date: