Volunteer Sign Up

Please complete this form only AFTER you have attended a Digital Literacy Orientation

Section 1: Contact Information
Name*
First Last
Name Tag Preference*
How do you want your name to appear on a name tag?
Unisex T-Shirt size*
Black polo with white logo, available in sizes small-2XL
Email*
Cell Phone*
Address*
Street Address Address Line 2 City ZIP Code
Section 2: Background Information
Birthdate*
Month
Day
Year
Gender*
Race*
Employer/Organization*
Enter N/A for none
Position*
Job title/Retired/Student
Do you have any medical conditions that Literacy Rochester should be made aware of?
Leave blank for no response
Section 3: Operations & Confidentiality Policy
Read and check all*
- I have received a copy of the Volunteer Position Description and agree to follow the guidelines set forth.
- I agree to volunteer for a minimum of six (6) months (for Fieldwork Students only - the entirety of the semester)
- I understand a typical shift lasts three (3) hours
- I will notify program staff immediately by text, phone, or email if any emergency will keep me from completing an assigned shift
- I will notify program staff of a vacation or other conflict that requires an absence from an assigned shift
Confidentiality Policy: Typing your name below indicates your agreement to follow the terms set below.*
As a volunteer I may have access to the personal information of program customers. I agree that I will never retain, share or otherwise use any personal information of program customers other than to record such information as may be necessary on an online or paper form.
Section 4: Emergency Contact
Name*
First Last
Relationship to Emergency Contact*
Other (Relationship to Emergency Contact)
Cell Phone*
Address (if different)
Street Address Address Line 2 City State ZIP Code
List any specific digital skills or areas of expertise
Example: Google Apps, Microsoft Office, Data analysis, Training experience, Resume writing, Publisher, Photo editing software, Financial literacy, etc.
Comments

Please complete this form only AFTER you have attended a Digital Literacy Orientation

Section 1: Contact Information

Section 2: Background Information

Section 3: Operations & Confidentiality Policy

Section 4: Emergency Contact