Volunteer Application

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He/Him/His, She/Her/Hers, They/Them/Their
Preferred method(s) of contact
Additional Information
Collection and Protection of Personal Information: Volunteer information is held in the strictest of confidence. I understand that my personal information will not be used or disclosed for purposes other than those for which it is collected or as required by law and that HIV Community Link contact list is neither given nor sold to any other organization/company. Information is stored within the agency’s data base and is only accessed by authorized users. Hard copy personal information is stored in locked file cabinets.
Confidentiality: As a volunteer of HIV Community Link, I acknowledge that I will be exposed to client information that is confidential. I will not disclose any such information to persons or organizations other than HIV Community Link.*
Waiver: I waive and release any and all claims for myself, my heirs, executors, and administrators against HIV Community Link, its agents, employees and licensees in conjunction with any injury, illness or death which may directly or indirectly result from my participation in volunteering for HIV Community Link.
Media Consent: I understand that while volunteering for HIV Community Link , my image may be reproduced, edited and used in whole or in part for any and all media including, without limitation, print, audio-visual, multi-media, and /or exhibition purposes, in any manner, in perpetuity and throughout the world. I understand and agree that I have no rights to any benefits derived from any such image.
Email: I understand that HIV Community Link uses email as an official means of communication with its volunteers. If provided with this application, I understand my email address will be used to communicate with me. Examples of such communication include monthly volunteer E-newsletters, invitations, etc.
Declaration: I hereby certify that the above information is true and complete to the best of my knowledge.