Volunteer Application Serve alongside us as we welcome our neighbors to Memphis. Let's get started. Name* First Last Preferred Name Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Cell Phone NumberHome Phone NumberEmail* Birthdate MM slash DD slash YYYY Company/ Employer Occupation Gender* Male Female Prefer Not to Answer Do you have your own transportation and car insurance?* Yes No What is your current church affiliation or place of membership? Are you involved in church groups/or committee? If yes, please list: What languages do you speak?Please note language and fluency. - Speaking/Reading/Writing - Beginner/Intermediate/fluent Educational background and professional training and/or degrees How did you hear about World Relief? Current Volunteer Church Event Friend/Family Social Media Website Work Other Please describe any cross-cultural experience (volunteer/mission/academic/professional).*Please list any other volunteer experience you have.*What do you hope to gain from your experience? What difficulties do you think you may face?*What type of volunteer opportunity interests you most? (All volunteer opportunities are currently virtual)?* Host Home Volunteer Youth Mentor Conversation Partner Good Neighbor Team Roadrunner (Transportation) Donations & Apartment Set-up Availability/Weekly availability (morning, afternoon, evening for each day of the week)*Are you interested in learning about one-time volunteer needs?* Yes No Reference #1 First Name Last Name Email Relationship to applicant Reference #2 First Name Last Name Email Relationship to applicant Emergency ContactPlease provide contact information for someone we can call in case of an emergency. Name Phone Number Additional Phone Number Relationship to Applicant Mission, Vision and Values of World Relief World Relief is fostering a movement among local churches to create a welcoming community where refugees and immigrants thrive. In community with the local church, we envision the most vulnerable people transformed economically, socially, and spiritually. These are our core values: The Example of Jesus We serve those who are suffering from poverty and injustice, regardless of color, belief, or gender, as part of God’s plan to redeem, reconcile, and restore the world. We seek to follow Jesus by living holy, humble, and honest lives individually and corporately. People Staff, volunteers, clients, beneficiaries, donors, and partners are all important actors in fostering peace, love, and justice. We recognize and affirm World Relief as a multicultural organization and seek to understand and respect the multiplicity of cultures among us. As we seek change in the world, we recognize that we, too, are changed, by those we serve. Excellence & Improvement In all our program initiatives and support services, following best practices and standards in a manner that is sustainable to the community from a spiritual, social, and economic perspective. We also seek to apply our human and financial resources in ways that maximize impact and sustain benefits to the greatest number of people. Empowerment By prioritizing the leadership and participation of those we serve, whether people, churches, or local institutions, as critical to creating and sustaining change. We seek to catalyze a movement of worldwide volunteers to multiply impact, and we value capacity-building as a means towards that end. Partnership By seeking, facilitating, and promoting collaboration among all stakeholders, including local governments, the worldwide church, mission agencies, other NGO’s, and the business community, recognizing partnership as essential to serving the most vulnerable. We believe each expression of the worldwide Church has a unique and interdependent role in bringing peace and justice to the world. Prayer As the priority and foundational to accomplishing our mission.Mission, Vision and Values of World Relief Acknowledgement I have read the mission, vision, and values of World Relief. I understand them and I desire to work with World Relief to carry out the goals of the mission.Please Check One* I personally affirm World Relief's mission, vision, and values. I do not personally affirm, but I agree to work alongside an organization who upholds these values. Do you have other thoughts or comments about World Relief’s Mission and Values? Background Check*I understand that I must pass a criminal background check in order to volunteer with World Relief. Yes No Photography Release*I give World Relief permission to photograph me and use such photos in World Relief promotional materials and related publications without remuneration to me. Yes No Financial Agreement By selecting the "I Agree" option at the end of this form, I confirm that I do not expect any financial compensation for my services. PSEA World Relief defines the term ‘sexual exploitation’ as any actual or attempted abuse of position of vulnerability, differential power, or trust, for sexual purposes, including but not limited to, profiting monetarily, socially, or politically from the sexual exploitation of another. The term ‘sexual abuse’ means actual or threatened physical intrusion of a sexual nature, whether by force, coercion or under unequal conditions. World Relief has a zero-tolerance policy for exploitative and abusive relationships. Likewise, we will also not tolerate any actions that jeopardize employee security or the reputation of our organization. It follows, therefore, that interns and volunteers should have: - No sexual contact with children under the age of 18 (mistaken belief of age is not a legitimate defense) - No sexual contact with or intimate relationships with World Relief beneficiaries/clients. Acts of sexual exploitation and abuse will result in disciplinary action, up to and including dismissal. By signing this form, I agree to act in a professional and ethical manner in accordance with the Sexual Exploitation and Abuse Code of Conduct.Motor Vehicle CheckAll interns/volunteers must have a valid driver’s license and pass a Motor Vehicle Records Check in order to operate a World Relief vehicle, or a personal vehicle while on company business. By signing this form, I confirm that I am covered by personal liability and property damage automobile insurance that meets the minimum state requirements. I understand that I am responsible for all damage and liability claims to my personal vehicle. I affirm that any vehicle I operate while interning or volunteering with World Relief is owned by me or that I have express permission granted by the owner to operate this vehicle. I understand that if I permit anyone other than myself to operate my vehicle, I do so at my own risk and that my insurance may be implicated in the event of any injury or damage to property. Yes No (I will not be driving as part of my assignment) Release of Liability*By selecting "I Agree," I confirm that I am aware of the potential risks to which I may be exposed during the assignment that I have voluntarily accepted with World Relief. I have thoroughly investigated the conditions of my assignment with World Relief and fully understand the potential risks of serving in this particular capacity. With such knowledge, I hereby indemnify and hold harmless World Relief, and waive any and all legal claims against World Relief for any injuries, direct and consequential damages, or loss that may result from my service, assuming all of such risk unto myself. I agree Confidentiality and Health Policy By signing this form, I confirm that I am aware that World Relief clients or staff may have communicable diseases and I should use good hygiene practices and Universal Health Precautions when interacting with clients or staff. I recognize that client and staff health information is confidential, in accordance with state and/or federal law. World Relief cannot disclose information regarding medical status unless legally authorized by the client or other legal authority. Universal Health Precautions: • Use gloves when administering first aid • Avoid contact with blood and bodily fluids • Wash your hands with soap and water for at least 20 seconds. Other good health practices include: • During times of outbreaks of illness, avoid shaking hands or otherwise touching clients or other individuals while volunteering for World Relief, if at all possible • Refraining for volunteer work while having any symptoms of illness • Self-quarantining in accordance with CDC guidelines if exposed to any communicable disease that can be ready transmitted in World Relief volunteer scenarios I acknowledge that World Relief may suspend volunteer activities in order to safeguard public health, and I recognize that I could become ill from communicable diseases encountered during World Relief volunteer activities, despite taking Universal Health Precautions and practicing other Good Hygiene Practices. I assume this risk in my role as a volunteer. I understand that at any time, I may advise World Relief that I will suspend volunteering due to my concerns regarding any communicable illnesses. I also understand that if I have any symptoms of illness, I am not permitted to volunteer in any capacity that involves contact with others.Consent I agree to the Confidentiality and Health PolicyCAPTCHAThanks for completing this application! We look forward to connecting with you! The next step is to complete a one-hour, online World Relief General Orientation. You can access it HERE and you can start on this anytime! After completing the World Relief General Orientation, you’ll attend a one-hour World Relief Memphis Volunteer Orientation. We will share dates and times with you soon. For further information, please contact our Volunteer Coordinator, Carter Brinkley, at email@example.com.