Volunteers
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Add Volunteer To Kiosk
Dashboard
First Name
*
Last Name
*
Address
*
City
*
State
*
Zip
*
Phone
*
If you are with a group, please enter here:
Date of Birth
(Needed for Over 20 Hours)
Which Center
*
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Melbourne
Micco
Titusville
Where Would You Like To Volunteer?
Have you ever been convicted of a felony?
Have you ever been convicted of abuse, neglect or exploitation of the eldery?
Optional:
Email:
Interests?
Hobbies?
Special Talents?
Why Did You Choose Us?
Where Would You Like To Volunteer?
Working With Caregiver
Help with Special Events
Prepare Mailings
Clerical / Filing
Outdoor / Landscaping
Data Entry
Work In Daycare
1. I understand that registration with Brevard Alzheimer's Foundation does not restrict my choice of volunteer jobs: I am free to accept or reject any placement offered me.
2.I understand that I am not an employee of Brevard Alzheimer's Foundation and am not covered by Workers Compensation Insurance.
3.I understand that a criminal offense will not automatically exclude me from a volunteer position; however, certain convictions will exclude me from volunteering in some positions. I understand that information will be held confidential.
4. I understand that if I volunteer regularly more than 20 hours a week in the presence of clients or client data files, a Criminal Level 2 Background Check will be needed.
5. I give my permission for photographs to be used, without compensation, for publicity and news media purposes on the Brevard Alzheimer's Website, Facebook Page and print media.
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