Volunteer Application

Scully Learning Center Foundation (SLCF) requires volunteers to be involved with Developmentally Disabled youth and adults living in the Foothills area. Volunteers fill roles such as coaches, chaperones, mentors, team leaders, and “experience” leaders. This application to be a SLCF volunteer must be completed in its entirety prior to participation with SLCF. A background check is required for verification of the information provided. In addition to this form, ALL volunteers must complete an orientation.

Part I - General Information

All Information is required unless indicated as optional

Part II - Volunteer Interests

Please indicate the area(s) for which you would like to volunteer *

Part III - Previous Volunteer or Work Information

Part IV - Background Information

Do you use illegal drugs? *
Have you ever been convicted of a criminal offense? *
Have you ever been charged with neglect, abuse, or assault? *
Do you have a valid driver's license? *
Has your driver's license ever been suspended or revoked in any state? *
Are you First Aide/CPR certified? *

Agreement & Signature

Please read and sign below:

  • The relationship between SCL Foundation and volunteers is an "at will" agreement and this application may be denied or the relationship may be terminated for any reason.
  • The information I have provided will be verified by a background check or any other means deemed appropriate and I give permission to SCL Foundation to make inquiry of others concerning my suitability to act as a SCL Foundation volunteer.
  • In the course of volunteering for SCL Foundation, I may be dealing with confidential information and I agree to keep said information in the strictest of confidence.
  • I grant SLC Foundation permission to use my likeness, voice and words in media or in any form to promote activities of SLC Foundation.
  • I authorize SLC Foundation to periodically access and review state and federal criminal history records and make reasonable efforts to determine whether I have been convicted of, or under pending indictment for a crime that bears upon my fitness to be volunteer for this position of trust over individuals with disabilities and convey that determination to the qualified entity. I hereby release SLC Foundation, all persons, organizations, or government agencies from any damages of, or resulting from, furnishing such information.
  • I have read and agree to the SLC Foundation Code of Conduct which refers to the volunteer position I am applying for.

Code of Conduct

As a Scully Learning Center Foundation (SLCF) volunteer, I agree that while serving as a volunteer, I will:

  • Provide for the general welfare, health and safety of all SLCF participants and volunteers.
  • Dress and act in an appropriate manner at all times.
  • Follow the established rules and guidelines of SLCF and/or any agency involved with SLCF.
  • Report any emergencies to the appropriate authorities after first taking immediate action to ensure the health and safety of all participants.
  • Abstain from the consumption or use of alcohol, tobacco products and illegal substances while involved with any SLCF event.
  • Not engage in any inappropriate contact or relationship with participants and volunteers of SLCF.

Confidentiality Agreement

This agreement applies to all volunteers associated with and/or involved in the activities or affairs of the Scully Learning Center Foundation ("SLCF"). This includes all activity associated with SLCF at its main facility and all other locations.

All data, materials, knowledge and information generated through, originating from, or having to do with SLCF or member organizations or persons associated with our activities, including consultants, is to be considered privileged and confidential and is not to be disclosed to any third party. All pages, forms, information, designs, documents, printed matter, policies and procedures, conversations, messages (received or transmitted), resources, contacts, e-mail lists, e-mail messages, client, staff or public information is confidential and the sole property of the SLCF.

This also includes, but is not limited to, any information of, or relating to, our board members, participants, operations and activities. This privilege extends to all forms and formats in which the information is maintained or stored, including, but not limited to hardcopy, photocopy, microform, automated and/or electronic form.

Membership information, including all file information, is not to be disclosed to any third party, under any circumstances, without the consent of the SLCF Volunteer Coordinator and the Executive Director.

Any disclosure, misuse, copying or transmitting of any material, data or information, whether intentional or unintentional, will subject you to disciplinary action and/or prosecution, according to the procedures set by SLCF and any applicable state and federal laws.

My signature signifies I agree to these terms and will abide by, adhere to and honor all of the above.