RSVP of Central Oklahoma Volunteer Registration Form

Name*

First Middle Last

Birthdate*

Mailing Address

Street Address City ZIP / Postal Code

Email

Home Phone*

Cell Phone

Gender

Do you have any physical/medical limitations?

Describe your physical limitations:

Are you a past member of RSVP?

Are you a Veteran?

Do you drive?

Ethinicity

(You are not obligated to disclose your ethnicity. We request this information to only comply with federal civil rights laws.)

Have you ever been convicted of a criminal offense?

If yes, please attach an explanation of charges, date of offense and status of the charges on a separate sheet to be included with this application.

Employment Experience:

Special Skills/Interests:

How did you learn about RSVP?

Have you ever volunteered before?

Volunteer Experience (Current, Past, Preferred)

Days/Hours Available:

As a volunteer, you will receive free accident and personal liability insurance. Please provide the following information.

Emergency Contact

First Last

Relationship

Phone

Name of beneficiary for RSVP Supplemental Accident Insurance

First Last

Relationship

Phone

Please indicate if RSVP may have permission to use your likeness?

I hereby grant RSVP of Central Oklahoma to use my likeness in photographs/videos in any and all of its publications or on the World Wide Web, whether now known or hereafter existing, controlled by RSVP of Central Oklahoma in perpetuity. I will make no monetary or other claim against RSVP of Central Oklahoma for the use of these photographs/videos.
I do not give permission to use my likeness in photographs/videos to RSVP of Central Oklahoma.

Please indicate if RSVP may have your permission to perform a confidential background check?

I understand that RSVP may at their own expense and discretion choose to perform confidential background checks on any/all registered members. I hereby give my permission for such checks to occur.
I do not give permission to perform confidential background checks.

Do you prefer a magnet or pinback name badge?

Please type name here for Signature:*

Date*

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