Hastings Region Volunteer Application

Thank you for giving us the gift of your time and talent. We can't wait to meet you and work together!

Your Information
First Name
Last Name
Maiden/Other
Gender
Country
Address Line 1 *
Address Line 2
City *
State/Province *
Postal Code *
Home #
Cell #
Can you receive texts?
What is your preferred method of communication?
Date of Birth
Month
/
Day
/
Year
Your Occupation:

Emergency Contact Information
Emergency Contact Name:
Emergency Contact Phone:
Emergency Contact Relation:

Reference Information
Reference Name:
Reference Phone:
Reference Relation:

Availability
Your Availability:
Are you willing to be a substitute?

Physical Restrictions
Physical Restrictions:
Safe Environment Training
Have you previously completed Safe Environment training and a background check for the Diocese of Lincoln?
Choose one:
Safe Environment

Volunteer Positions (check all that interest you)
General
St. Joseph Gift & Thrift
Other

What prompted you to apply today?

Use of Volunteer Photo, Video, and Voice Release Form

I give Catholic Social Services of Southern Nebraska (CSS), consent to record, videotape, photograph my image, and/or voice in relation to the mission of CSS. These items may be used in the following ways while volunteering at CSS:

  • Company Intranet accessible by employees only
  • Company Website accessible via the World Wide Web to anyone
  • Printed employee newsletter
  • Printed client/donor communications (i.e. Catholic Register Newspaper)
  • Company Print/Digital Marketing Materials
  • Printed annual report
  • Company social media platforms (i.e. Facebook, etc.)

I understand that no special compensation will be provided to me for the use of my image and that I may not be informed in advance of the specific use of my image. I further understand that I may opt-out of this practice upon providing written authorization to CSS.

Use of Volunteer Photo, Video, and Voice Release Form permission given:
Use of Volunteer Release Form approval:
Digital Signature: