Thank you for your interest in volunteering with the Clintonville-Beechwold Community Resources Center!

When filling out this application, please be as thorough as possible so we can connect you with volunteer opportunities that best suit your interests.

If you don't have a background check on file or it is outdated, you will be prompted to fill out a new form and submit it to the CRC for review. Typical turnaround time is 72 hours. Once approved, you'll receive an email from Volunteer Local that includes a link to sign up for volunteer opportunities. Thank you!

What's your email address?

Your information


Required fields are marked with an asterisk (*). One of the fields below is a file upload/attachment, the file size must be less than 10MB.
Birthdate *

A valid date as MM/DD/YYYY (for example: 11/30/2015)
first name *
last name *
phone number *

For example, 123-456-7890
street address *
city *
zip code *
Profile Picture

The total size of any/all file uploads must be less than 10MB
Emergency Contact First Name *
Emergency Contact Last Name *
Emergency Contact Relationship to you? *
Emergency Contact Phone Number *
Volunteer Interests



















Waiver

By signing this application, I verify that the information provided is true, correct, and complete. I
hereby give my consent to The Clintonville-Beechwold Community Resources Center (CRC) to verify
this information, including contacting references, and unconditionally release CRC from all liability
which might result from furnishing the same. I understand that my acceptance as a volunteer is on a
conditional basis, and that CRC reserves the right to terminate the service of any volunteer whose
conduct and preference in any way reflects negatively upon the agency.

I grant full permission to the sponsors, organizers, and affiliates to use my name or my child’s name,
photographs, or any other record of participation in this volunteer service event for use in any
broadcast, telecast, or any other written account of the event for publicity purposes, without
compensation or remuneration.

If the applicant is under 18: I give my permission for my child to participate as a volunteer with CRC. I
understand that CRC staff are not responsible for the care of supervision of my child and I will not
hold CRC responsible if my child leaves the premises.

During the time you spend at the CRC or any of its programs or events you may see someone
you know who lives in your neighborhood or attends your school, church, or place of
employment. It is very important that you respect that person’s privacy and legal rights to keep
their information private. Even telling someone that you saw your neighbor, colleague, etc. at
the CRC is breaking the law.

There are in effect federal and state regulations, legal precedents and social work codes of
ethics that prohibit disclosure of any information obtained from a client in confidence,
including the client’s presence and/or status of receiving services without the client’s written
consent, except when disclosure is necessary to prevent serious, foreseeable and imminent
harm to the client or another identifiable person. In other words, as a CRC volunteer you are
required to maintain confidentiality unless you believe a client may harm him/herself, harm
another identifiable person, or a child is being harmed. In these cases, you are a mandated
reporter and as such have an obligation to report the situation to the supervisory staff person
on duty.

These regulations and ethical codes were designed to ensure the privacy of any individual
seeking services. It is not appropriate to talk about who is receiving benefits, share information
or photos in any way including on the internet and social media. Confidentiality includes the
client’s presence and/or status of receiving services. Confidentiality includes the safeguarding
of client records. Volunteers and staff are responsible for the confidential handling of all
information that we receive from our clients. Volunteers and staff are responsible to ensure
that records are secured in a locked environment at all times. Any volunteer or staff person
who violates these regulations may be held legally responsible.

I signify that I have read and am willing to comply with the above statement.