It is the policy of this organization to provide equal opportunities without regard to race, color, religion, national origin, gender, sexual preference, age, or disability.
Thank you for completing this application form and for your interest in volunteering with us.
Which days are you typically available for volunteer assignments?
Tell us in which areas you are interested for volunteer placement:
Are you applying for a student internship?
Summarize special skills and qualifications you have acquired from employment, previous volunteer work, or through other activities, including hobbies or sports.
Summarize your previous volunteer experience.
Mississippi Code Section 93-21-109 (2): Any employee, contractor, volunteer, or agent of any other entity in possession of information which could tend to identify a victim of domestic violence, who discloses any information which is exempt from disclosure under the Mississippi Public Records Act of 1983, or makes any observation or comment about the identity or condition of any person admitted to a shelter or receiving services of a shelter, unless directed to do so by an order of a court of competent jurisdiction, shall be civilly liable to the person whose personal information was disclosed in the amount of Ten Thousand Dollars ($10,000.00), plus any compensatory damages that the individual may have suffered as the result of the disclosure.
At our Center, confidentiality and safety of our clients and staff are of utmost concern. As a volunteer, it is vital that you understand the confidential nature of any information you may gather while at the Center or working on behalf of the Center. By completing this application, you agree to never divulge the location of our shelters and to treat with confidentiality any information about any person who contacts the Center for services, including client identities, medical, social service, legal or other records. You agree not to discuss or divulge any information related to Center business or to any individual you see on behalf of the Center with anyone other than the appropriate Center personnel.
Use your mouse, digital pen, or finger to add your signature below. By adding your signature here, you are agreeing that you understand and will abide by the GCCFN Confidentiality Policy listed above.
