ABOVE AND BEYOND FAMILY RECOVERY CENTER
Volunteer Application
All 4 (four) pages of this application must be completely filled out and signed for volunteerment consideration. This application will be considered incomplete and will not be accepted for candidature if reference is made to a resume, or if the application is not signed by the applicant. Above and Beyond Family Recovery Center and its people, fully subscribe to the principles of Equal Opportunity. It is our policy to provide volunteer opportunities based on qualifications, without regard to race, color, religion, national origin, age, sex, veteran status, disability, or any other basis prohibited by federal, state, local and natural law. In accordance with requirements of the Americans With Disabilities Act, it is our policy to provide reasonable accommodation upon request during the application process to eligible applicants in order that they may be given a full and fair opportunity This form and all accompanying behaviors comply fully with applicable laws and the information requested on this application will only be used for purposes consistent with those laws. Applications are only accepted for volunteer positions currently available and will only be considered for thirty (30) days from today’s date or until the position applied for is filled, whichever first occurs.
POSITION APPLIED FOR:
Please Print LEGIBLY (please take your time so we don’t have to ask you to fill it out again)
Departmentyou’reapplyingin:
❑ Counselor ❑ Story Capturing ❑ Garden ❑ General ❑ Administration ❑ Other: ________
Have you ever worked for another Addiction Treatment facility? ❑ Yes ❑ No If so, please give facility name(s), position titles and approximate dates (beginning and final): _____________________________________________________________________
Do you have any experience with the negative aspects of addiction? (describe): ______________________________________________
Have you visited our website (www.anb.today)? Yes ❑ No ❑ What do you know about us? ______________________________________________
What are your expectations for this volunteer position?
How much time would you like to spend in a volunteer role? __________________________________________________________________
What skills, abilities and qualities would you bring to a volunteer role? __________________________________________________________________
Are you available for off premises work? ❑ Yes ❑ No If weekend, evening, and overtime work is requested, would it be a problem? ❑ Yes ❑ No
How far do you live from our location (please calculate miles and approximate time): ________________________________________
Date available to begin: _________________ May we contact your current employer? ❑ Yes ❑ No Are you over 18 years of age? ❑ Yes ❑ No
Do you know any of our employees? ___________________ _ If so, whom? ______________
Do you prefer to work independently or in a group? _______________ Are there tasks you do not want to do as a volunteer? _____________________
What would you say are three of your strengths?
What would you say are three of your weaknesses? _______________________________________________________________
Have you been convicted of a felony within the last seven years? Yes ❑ No ❑ Date of Conviction:___
Have you been charged or convicted within the last seven years of sexual offenses, embezzlement or other dishonest conduct, an offense involving the use of a weapon, physical assault or other violent crimes? Yes ❑ No ❑ If yes, please explain on the Additional Comments section.
Note: Answering “yes” to either one of the above two questions does not automatically exclude you from further consideration for a volunteer position with us. If yes, please explain in the Additional Comments section, including the penalty imposed and what you have done to correct the behavior that caused it
ABOVE AND BEYOND Page 1 of 4 2942 West Lake Street, Chicago, IL 60612 p 773.940.2960
__________________________ Today’s Date:
____________________
Last Name First Previous Surname(s) Last 4 Digits of Social Security Number Street Address City State Zip E-Mail Address Home Telephone Number Cell Telephone Number Emergency Contact & Relationship Home Telephone Number Cell Telephone Number
Mobility and Transportation
Do you have a valid drivers license? Yes ❑ No ❑ State: _______License No.:
Have you had any tickets? Yes ❑ No ❑ If yes, please explain:
Has your license ever been suspended or revoked? Yes ❑ No ❑ If yes, please explain:
Do you have any DUI or DWI convictions? Yes ❑ No ❑ If yes, please state when you were convicted and explain:
Do you understand that you are assuming full responsibility for getting to and from your volunteer opportunity and that you are personally responsible for any volunteer-related liability and/or expenses, including car rental liability and/or damage expenses, incurred that fall outside of your regular personal coverage? Yes ❑ No ❑ Initials:
Have you taken any illegal drugs in the last 30 days? Yes ❑ No ❑ If yes, what and when?
Additional Comments and Things We Should Know About (be frank and honest):
Education (May or may not be considered depending on job applied for)
Describe any educational degrees, skills, training or experience you believe are relevant to the job applied for:
Undergraduate College or University
Technical/Licenses/Certifications and other noteworthy educational pursuits or accomplishments including Graduate Degrees
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Name, City and State of Educational Institution Graduated? Name of School (city, state) Type of Degree Received or Expected Major Minor Grade Point Yes No Overall GPA High School/GED
Employment and Volunteer History
(Please complete for all full-time or part-time employment beginning with your most experiences)
recent
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Company Name Telephone # Address Dates Employed From To Name of Supervisor May we contact? Yes ❑ No ❑ Rate of Pay Start Last State Job Titles and Duties Reason for leaving Company Name Telephone # Address Dates Employed From To Name of Supervisor May we contact? Yes ❑ No ❑ Rate of Pay Start Last State Job Titles and Duties Reason for leaving Company Name Telephone # Address Dates Employed From To Name of Supervisor May we contact? Yes ❑ No ❑ Rate of Pay Start Last State Job Titles and Duties Reason for leaving OTHER RELATED EXPERIENCE:
If you had a “magic wand” and could create your perfect volunteer opportunity, what would it look like?
Have you ever reluctantly resigned a volunteer opportunity? Yes ❑ No ❑ If yes, explain:
Did you experience any disappointment during your active volunteerment? Yes ❑ No ❑ If yes, please explain:
Were you given a performance evaluation within the last 12 months of active volunteerment? Yes ❑ No ❑ If yes, what was the range of scores used and what score did you receive?
Have you signed any form of non-compete or non-disclosure agreement(s) with any other organization that might cause you problems in volunteering for Above & Beyond? Yes ❑ No ❑ If yes, please explain: (Applicant alone accepts full responsibility for any consequences resulting from improper or illegal contractual behaviors or obligations)
APPLICANT’S ACKNOWLEDGMENT
I certify that the answers given herein are true and complete to the best of my knowledge. I understand that any misrepresentations, omissions of facts or incomplete answers in this, or any application conversation or document, will disqualify me from further consideration for volunteering. I further understand that, if I am accepted as a volunteer, any misrepresentations or omissions of facts on this or any application document that surface afterwards will be cause for my dismissal at any time without prior notice or explanation (due to potential liabililty)
I understand that, if accepted, my volunteerment is not for a specific term and may be terminated by me or my benefactor(s) with or without notice or cause at any time. I further understand that no oral promise, benefactor(s) policy, custom, business practice or other procedure (including the Personnel Handbook or any relevant manuals) constitute a contract or modification of the at-will relationship between myself and my benefactor(s).
I understand that applicants for certain volunteer positions may be required to occasionally re-qualify based on hereforto unknown criteria. For example, as I advance I may be required to take job-related tests, i.e.; take medical tests; allow background investigations; take spontaneous drug tests; and others. If I am offered an opportunity or start before any required test is completed, my continuance is contingent on sustained satisfactory results on all eventual tests.
I acknowledge that, if accepted, I will be voluntarily participating at my own risk, which include travelling to and from as well as direct participation with populations that are unpredictable as well as staff members and fellow volunteers who may occasionally operate in ignorant or negligent ways I absolve Above and Beyond Family Recovery Center, it’s employees, associates, Board of Directors and Clients of any responsibility whatsoever that regards my well-being.
Finally, I understand that everything that I am signing off on is required by lawyers and does not indicate, in any way, the deep gratitude that Above and Beyond has for my selfless act of volunteering. I accept the fact that the needs of the people whom I am serving and helping to serve could not be met without me. I move forward with this opportunity in union with the founding mission of Above and Beyond and will serve its constituents without regard for self-gain even though I am well aware of the universal truth that the only way I can “get” is by “giving”.
Signature: ___________________________________________________________________________
Date: _______________
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