Apple Corps Leader

Page 1

Commitment to the Apple Corps Leaders Program

I, hereby commit to the mission of the Houston Food Bank in Leading the Fight Against Hunger. As an Apple Corps Leader, I will

Be at least nineteen year old and commit to volunteer at least two shifts per month for a period of one year.
Understand that you MUST volunteer at least two shifts prior to becoming an Apple Corp Leader.
Attend an initial Orientation & Safety session and before my first shift as an ACL.
Model Professionalism at all times, and adhere to applicable dress codes.
Attend project specific training, and to contribute feedback in ACL-led meetings.
Be a dedicated ambassador for the Houston Food Bank.
Attend the annual ACL Recognition Luncheon or Dinner.
Authorize the Houston Food Bank to obtain a report from Verified Volunteers containing back-ground information about me.

Personal information

First Name

Last Name

Street Address

City

State

Zip Code

Email Address

Phone

Emergency Contact

Emergency Contact Phone

Relationship

Affiliation (if applicable)

Employer

Occupation

Do you have any health concerns, allergies, or special
requirements of which HFB should be aware?

If yes, please briefly explain.

Are you able to perform the essential functions of chosen assignments with or without reasonable accommodation?

YesNo

Have you volunteered at the Houston Food Bank? (PLEASE NOTE: You MUST volunteer at least two shifts BEFORE your application will be reviewed for the leadership program.)

YesNo

Page 3

Volunteer Confidentiality Agreement

I, do hereby acknowledge that during my volunteer service for the Houston Food Bank, I will have access to confidential information. I agree that i shall not disclose any such confidential information maintained by the Houston Food Bank to any unauthorized person. I will handle and retain information in a secure work area, free from view of others, at all times while in my possession. I acknowledge that a proven breach of confidence could be cause for the removal from my volunteer position.

I Agree the above

Page 4

ACL Mandatory Background Check Instructions

ACLs are often called upon to be the face of the HFB at on-site and/or off-site events, may be placed in positions with direct client contact, or may handle sensitive information in some HFB departments.

In our efforts to ensure the highest possible level of protection for both the HFB and for ACLs, Volunteer Services requires a Criminal Background Check (CBC) for both new and veteran ACLs. The HFB has partnered with Verified Volunteers for this purpose.

The cost of a Verified Volunteers CBC is $9.00. ACLs can choose to pay for some or all of the cost (another way to support the HFB). If you are unable to pay, the cost will be covered by the HFB. Once completed you can share your CBC with other organization with whom you volunteer, provided they also use Verified Volunteers.

Please go to http://www.verifiedvolunteers.com/ to initiate the CBC. Click on "Get Started," then click "Start My Background Check." The GOODDEED code you will need is: yunn4ou

I have my CBC

Office Skills General Office duties (filing, copying etc.)Data EntryTelephoneMS WordMS AccessMS ExcelNone of the above	Do you have experience in any other areas? Customer ServicePresentationTeachingSales (Closing the deal)FundraisingRecruitingNone of the above
Language SpanishFrenchESLOther (please specify:)