Volunteer Application Form

Volunteer Application Form

Application form, consent form and media release for all potential volunteers at Jeremiah's Inn.

Step 1 of 3

  • Please indicate above which opportunity you are interested in : Food Pantry Assistant, Food Drive Volunteer, CHOPPED!Worcester Volunteer, Administrative Volunteer, Evening Meal Program (EMP), Bake-a-Cake Program (BAC)
  • If you are volunteering as part of a group please enter group name above. If you are volunteering as an individual you may leave blank.
  • Availability

    (i.e. Holidays, Fundraisers, Food Drive, etc.)
  • Affiliations

  • Limitations and Background

  • By initialing above I understand that due to the vulnerable populations that Jeremiah's Inn works with all Food Pantry volunteers must pass a CORI background check.
  • Volunteers for Jeremiah's Inn are requested to arrive dressed appropriately for the work that they will be performing. This dress code has been developed with the safety of volunteers in mind, following work place safety standards and are designed to respect our clients. Please adhere to this code to insure that you will be able to fully take part during your day(s) of service. Volunteers arriving dressed inappropriately will not be allowed to take part unless suitable accommodations can be made. Volunteers must wear flat, closed-toed shoes. Please do not wear shoes with heels more than half an inch. Volunteers should not wear revealing or tight-fitting clothing. Do not wear tank tops, sleeveless or low-cut shirts, short-shorts or tight pants (including yoga pants, leggings, or tights). Acceptable clothing includes shirts that cover the stomach, and upper arms and chest, shorts that come within three inches of the knees, and long pants. A hat or hairnet is required for volunteers handling food. Hats should be brought from home (we suggest baseball caps) Please do not wear large /dress hats. Disposable gloves are required for volunteers handling food and will be provided by Jeremiah's Inn. If you find that you have any questions regarding this policy, please contact us at 508.755.6403 ext. 10 or info@jeremiahsinn.com. We will be happy to discuss this and to insure that you have an enjoyable experience volunteering with Jeremiah's Inn.
  • I hereby release and hold harmless Jeremiah’s and any of its employees from any liabilities and claims arising from my participation in the volunteer program. I agree that I will never prosecute or in any way aid in the prosecuting of any demand, claim or suit against Jeremiah’s Inn, any officer, agency, or any employee acting officially and/or in good faith, for any loss, damage or injury to my person or property that may occur because of me taking part in the Volunteer Program. I accept full responsibility for the cost of treatment for any injury. I also understand and agree that I may be held liable for any damage or loss to Jeremiah’s Inn property and facilities that is caused by my own negligence, gross negligence, willful misconduct or fraud. I also understand and agree that I may be held liable for any damage or loss to any third party that is caused by my own negligence, gross negligence, willful misconduct or fraud. I further understand that Jeremiah’s Inn is fully insured and that any claims for any injuries must first be made against personal/family insurance and then against Jeremiah’s Inn Insurance. I accept that claims are limited to that which insurance provides and will not seek damages beyond those limits. By initialing here, I agree to the above and understand that I am a volunteer and that I am not an employee of Jeremiah's Inn.
  • References

  • Person to call in case of an emergency

  • Electronic Signature