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Contact Information
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Volunteer Interests
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Background Information
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Policies and Acknowledgement
AIDS Alabama Volunteer Application
Your Name
Preferred Name
Phone number
Email
Home Address
Gender
Non-Binary
Trans Woman
Trans Man
Female
Male
Prefer Not to Disclose
Date of Birth
MM
/
DD
/
YYYY
Emergency Contact
Emergency Contact Relationship
Please select
Parent
Spouse
Other Family Member
Friend
Other
Please select
Emergency Contact Phone
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01
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Contact Information
02
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Volunteer Interests
03
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Background Information
04
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Policies and Acknowledgement
Are you interested in volunteering with AIDS Alabama in Birmingham or AIDS Alabama South in Mobile?
AIDS Alabama (Birmingham)
AIDS Alabama South (Mobile)
AIDS AL Event Volunteer Opportunities
Mark all that apply.
AL HIV Advocacy Day
Dining Out for Life
Funky Food Truck Festival
Holiday Wish
World AIDS Day
Holiday Open House
AIDS AL Ongoing Volunteer Opportunities
Mark all that apply.
HIV Testing & Prevention Education
Programs
Advocacy
(CALA) Centro de Acceso para Latinos de Alabama
Way Station
Beautification (Housing Program Support)
Development Committee
Office/Clerical
AIDS AL South Event Volunteer Opportunities
Mark all that apply.
Dining Out for Life
Delta Red Walk
Other events & fundraisers
AIDS AL South Ongoing Volunteer Opportunities
Mark all that apply.
Bulk Mailing
Food Pantry
Food Pantry Delivery
Translators
Community Outreach
Office Assistance
HIV Testing (Certification Required)
Serving on a Committee
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01
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Contact Information
02
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Volunteer Interests
03
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Background Information
04
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Policies and Acknowledgement
What motivated you to volunteer with AIDS Alabama?
Optional
Previous Volunteer Experience
Optional
Special Skills, Certifications, or Qualifications
Optional
Have you ever been convicted of a Felony?
If yes, please explain.
Note: All applications are kept strictly confidential & convictions will be reviewed on a case by case basis.
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01
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Contact Information
02
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Volunteer Interests
03
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Background Information
04
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Policies and Acknowledgement
CONFIDENTIALITY AGREEMENT
As a volunteer, board member, staff member, associated agency representative, intern, contractor or vendor for AIDS Alabama, my acknowledgement below indicates my commitment to the following policies and guidelines, and I understand that if it is shown that I have violated any of these policies or guidelines, my involvement/employment may be terminated.
Through involvement with AIDS Alabama, I may become privy to an individual’s personal health, including HIV status. It is the general policy of AIDS Alabama that such information should remain confidential.
a) The duty to maintain confidentiality derives from an individual’s right to privacy, which is established by federal and state constitution, federal and state statutes and regulations; and common law doctrines. Additionally, ethical guidelines for various professions require, with limited exception, that information concerning a client remain confidential.
b) Everyone has a right to privacy concerning disclosure of information related to their personal health, including HIV status. The right to decide to whom information may be disclosed belongs to the individual about whom the information pertains, and not agency employees or anyone representing the agency.
c) Disclosure of personal health, including HIV-related information, could result in a loss of privacy, harassment and discrimination; unauthorized disclosure by an agency representative could lead to individual liabilities as well as criminal or civil penalties against the agency and its representatives.
d) Breaches of confidentiality can lead to a loss of trust that will jeopardize the continued provision of services to persons who have compromised health, including HIV infection, and their families.
Consent
Have you read, do you understand, and do you consent to AIDS Alabama's Confidentiality Agreement?
Yes
No
VOLUNTEER EXPECTATIONS & RESPONSIBILITES
Volunteers may expect that staff and other AIDS AL volunteers will…
-Demonstrate utmost reverence for privacy & confidentiality
-Be respectful to all people
-Provide a welcoming environment in which you can work
-Provide resources and tools for the projects you are working on
-Provide a support network for you in your activities
-Help you understand the amount and types of work required for a given volunteer opportunity
-Be accommodating and understanding
-Accept and affirm you
AIDS AL expects volunteers will…
-Demonstrate utmost reverence for privacy & confidentiality
-Be respectful to all people
-Be a good representative of AIDS AL and our message while volunteering
-Be friendly to all people: familiar faces, newcomers, and fellow volunteers
-Act in accordance with
Who We Are
-Educate yourself about the issues we are working on
-Work with us to find volunteer opportunities that fit your interests and skills
-Let us know in advance if you cannot show up for a volunteer opportunity that you committed to
Consent
Have you read, do you understand, and do you consent to AIDS Alabama's Volunteer Expectations and Responsibilities?
Yes
No
VOLUNTEER AGREEMENT & LIABILITY WAIVER
The undersigned (hereinafter “Volunteer”) has agreed to volunteer professional and/or personal services (hereinafter “Volunteer Services”) to AIDS Alabama, Inc. (hereinafter “AIDS Alabama”). Volunteer acknowledges and agrees that Volunteer is not an agent or employee of AIDS Alabama and is not entitled to any employment benefits from AIDS Alabama or any special rights or privileges afforded to the employees of AIDS Alabama.
Volunteer acknowledges and agrees that Volunteer Services may involve inherent risks. Volunteer assumes all risks related to the Volunteer Services, and hereby waives all liability claims of any nature against AIDS Alabama – as an entity and as its individual subsidiaries, divisions, and affiliates, related enterprises, successors, assigns, officers, insurers, agents, and employees – that are related, directly or indirectly, to the Volunteer Services, Volunteer’s presence at any AIDS Alabama property, Volunteer’s presence and/or participation in any AIDS Alabama-sanctioned event, Volunteer’s presence and/or participation in any AIDS Alabama-sanctioned activity, and/or any act committed against the Volunteer by any other volunteer or participant in any AIDS Alabama-sanctioned activity or event who is not an employee of AIDS Alabama.
Volunteer agrees that in executing this document, Volunteer does not rely and has not relied upon any representation or statement made by any of AIDS Alabama’s officers, agents, or employees regarding the subject matter, basis, or effect of this document. This document shall be interpreted in accordance with the plain meaning of its terms. This document shall be governed by, and construed and interpreted in accordance with, the laws of the State of Alabama without regard to principles of conflict of laws.
Consent
Have you read, do you understand, and do you consent to AIDS Alabama's Volunteer Agreement & Liability Waiver?
Yes
No
Digital signature
BY SIGNING I CERTIFY THAT I AM THE INDIVIDUAL NAMED IN THIS APPLICATION AND THAT THE INFORMATION ABOVE IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE.
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