This document contains a volunteer application form for All Children's Education & Conference Center. It requests information such as contact details, availability, interests, skills, and a signature agreeing to follow policies. Volunteers must complete an orientation. The form collects information to evaluate applicants and make appropriate volunteer placements that support the organization's mission of helping children.

1. All Children’s Education & Conference Center,
701 4th Street South, St. Petersburg, FL 33701
Phone: (727) 767-6780
Fax: (727) 767-2119
E-mail: Healthystartfederal@allkids.org
VOLUNTEER APPLICATION FORM
Preferred Start Date _________________________ Total Volunteer Hours Needed __________________
___________________________________________ _________________ ___________________
Name (first,initial,last) Date of Birth Date
___________________________________________________________________________________________
Address State Zip Code
_________________________________________ ______________________________________________
Phone Number E-mail Address
___________________________________________________________________________________________
Emergency Contact Name & Number
Hours available to volunteer. Please check off the day of the week and indicate times.
Monday: Friday:
Tuesday: Saturday:
Wednesday: Sunday:
Thursday: Seasonal:
Education
High school _____________________________________________ Year graduated ______________________
College/Trade school ______________________________________ Year graduated ______________________
Degree ____________________________________ Major/Minor _____________________________________
Reason for volunteering? (course requirement, volunteer or community service hours, etc.)
____________________________________________________________________________________________
____________________________________________________________________________________________
Are there any physical conditions that would limit your ability to perform certain duties? ___Yes ___No
If yes, what accommodations are required __________________________________________________________
____________________________________________________________________________________________

2. List any special skills, previous volunteer experience or trainings: ______________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
Interests? (check all that apply)
Advocacy Training
Research Advertising
Fundraising Outreach/Program Awareness
Graphic/Web Design Health Education
Organizing Events/Event Planning Recruitment and Retention
Writing and Communications CREED Member
Community Service Other________________________
How did you hear about us?
___Advertisement/Flyer ___Referred by a friend/volunteer ___Other_________________________________
VOLUNTEER AGREEMENT AND CODE OF CONDUCT
As a volunteer :
I agree to abide by all policies and procedures of the St. Petersburg Healthy Start Federal Project. I will conform to
all rules and regulations commonly applying to employees of All Children’s Hospital, including safety, discrimina-
tion, harassment, and confidentiality.
I give consent to Healthy Start Federal to use and reproduce my name, voice, and/or likeness in connection with
any advertising, programming, and/or promotion for St.Petersburg Healthy Start Federal Project in any media it
chooses.
I further agree to:
 Support the mission, goals, and efforts of Healthy Start Federal with a positive attitude.
 Approach my volunteer job responsibilities with professionalism.
 Treat all individuals with respect and kindness.
 Promote goodwill by handling contacts with staff, other volunteers, and program participants, in a spirit of
courtesy and cooperation.
 Report to my volunteer job physically and mentally fit for duty.
 Provide appropriate notice of unavoidable absence or tardiness.
 Deal fairly with all staff, volunteers, and program participants without regard to their gender, race, ethnicity,
religion, age, sexual orientation, citizenship, handicap or disability.
*If volunteer is under the age of 18, please have guardian sign for approval.
_______________________________________________ ________________________________________
Guardian Signature Date
_______________________________________________ ________________________________________
Volunteer Applicant Signature Date
*All applicants must complete volunteer orientation at All Children's Hospital.
PLEASE ATTACH RESUME AND RETURN THIS FORM TO ST.PETERSBURG HEALTHY START FEDERAL PROJECT,
777 4TH STREET SOUTH, DEPT# 7445, ST. PETERSBURG, FL 33701 OR FAX (Attn: Amber Tellis).
SUBMIT FORM