C5 GEORGIA
Volunteer Application

Volunteer Information

Thank you for your interest in volunteering with C5 Georgia! Please fill out this volunteer application and a member of the C5 Georgia team will be in touch with you within 3 business days to schedule phone interview.

Volunteers are grouped according to their contact with youth. Please select the type of volunteer work in which you are interested.

Type of Volunteerism	Contact with Youth	Background Check Required	References Required	Training or Orientation Required
Program Logistical Assistants	Minimal to None	No	No	Task Specific
Content Expert Speakers/Panelists	Supervised	No	No	30 minutes
Pathway Support Senior Interviewer	Unsupervised	Yes	Yes	1 Hours

Please select the type of volunteering in which you are interested. *

Program Logistical Assistant

Content Expert Speaker/Panelist

Pathway/Program Assistant

Student Interviewer

First Name *

Last Name *

Age: 18+ *

Yes

No

Phone Number *

Email Address *

Have you been employed by or volunteered with C5 Georgia in the past? If yes, indicate the last date of service/employment. *

No

Yes, Yes,

Volunteer Agreements and Certifications

Please read and check each box to indicate understanding and agreement. *

I agree to abide by rules and regulations established by C5 Georgia in the interest of the health and welfare of youth and staff.

I understand that unless C5 has received the satisfactory results of a criminal background screen (conducted with my consent) and I have participated in the minimum training required by C5, I am not authorized to supervise youth, interact with youth without a C5 staff member present, and must be escorted when at C5 events. I further understand that at no time is it acceptable for me to be alone with a youth and out of sight and beyond the hearing distance of a staff person.

C5 Georgia sets the highest standards for youth and staff. I understand and agree that I am required to immediately report to the Director any behavior that does not meet these standards. unacceptable behaviors include, but are not limited to, sexual activity, drug or alcohol use, emotional concerns/issues, and physical concerns/issues among youth, staff, or between youth and staff. I understand that failure to report these behaviors may constitute personal negligence on my part and result in termination of my service.

I understand that C5 Georgia is not responsible for, and therefore does not carry insurance to cover the repair or replacement of personal vehicles or personal property damaged or stolen during the course of my volunteer service, regardless of where and how the damage or theft may have occurred.

In the event that my emergency contact cannot be reached and I am incapacitated, I hereby give permission to C5 Georgia to secure treatment for me at the nearest health facility.

I agree and give consent to C5 Georgia to use films videos and/or photographs containing me or my likeness for brochures, advertisements, and/or any other publicity purpose.

I understand that C5 Georgia is committed to keeping my e-mail address confidential. C5 Georgia does not sell, rent, or lease our subscription lists to third parties, and will not provide my personal information to any third party individual, government agency, or company at any time unless compelled to do so by law.

I acknowledge that I have read the above and I agree to the terms listed. I certify that the statements made in this volunteer application are true and correct and have been given voluntarily.

I recognize my right, as a volunteer, to discontinue my service at any time and for any reason. I also understand that C5 Georgia has the right to discontinue my volunteer service relationship.

C5 GEORGIA Volunteer Application

Volunteer Information

Volunteer Agreements and Certifications

C5 GEORGIA
Volunteer Application