Become a BDI Volunteer

Become a BDI Volunteer

Thank you for volunteering!
Please complete the following form and click the "Submit Application" button.
NOTE: All items on the form are required.
 

VOLUNTEER APPLICATION FORM

 

Last Name:  
First Name:  
Date of Birth:  
Address:  
City:  
ZIPcode:  
Home Phone:  
Cell Phone:  
E-mail:  
Emergency Contact:
Full Name:  
Home Phone:  
Work Phone:  
Relationship:  
Availability:
In order to best serve the BDI, it is necessary for volunteers to be available a minimum of five hours a month. Please fill in the hours and days you are available to volunteer.
Sunday:  Morning     Afternoon     Evening
Monday:  Morning     Afternoon     Evening
Tuesday:  Morning     Afternoon     Evening
Wednesday:  Morning     Afternoon     Evening
Thursday:  Morning     Afternoon     Evening
Friday:  Morning     Afternoon     Evening
Saturday:  Morning     Afternoon     Evening
Miscellaneous Information:
 
Please add any comments about your schedule or any medical, physical or other limitations that may limit your volunteer work.
Do you have diabetes?   Yes    No    If Yes, Type 1    or Type 2
Why do you want to become a volunteer with the BDI?
Interest Areas / Experience:
 
Please indicate the areas where you would like to volunteer.
Please number the activities in order of preference, with #1 being the most preferred. You will be asked to volunteer for activities based on your interests, availability, and BDI needs.
Office Work:
Filing Making Copies
Answering Phones Making Calls
Inputting Data  
Please include any computer programs you are familiar with:
Events:
Planning Finding Rooms
Order/Pick up Food Set Up/Clean Up Room
Event Greeter Photography/Webphotos
Designing Flyers
 		 Creating Graphics
 
Outreach:
DiaBuddies
 
 		 Manning Booths at
       Health Fairs
 
Fundraising/
Marketing:
Compiling Materials
        Packets		 Delivering Packets
        to Doctor Offices
Helping with Mailings
 		 Publicizing Events and
        Workshops
Other special skills or interests you would like to share:
What type of experience do you have working with people or with the public?
Have you done volunteer work before? If yes, where?
Have you ever been terminated or dismissed from a volunteer program?
If so, why?
T-Shirt Size:   S    M    L    XL    XXL   

VOLUNTEER AGEEMENT
In signing the agreement, I understand and agree to follow BDI policies and the following statements:

  1. I authorize the BDI to seek emergency medical treatment for me in case of accident, injury or illness.
  2. I agree to abide by BDI policies and procedures presented to me during volunteer training and as updated thereafter.
  3. I have read, agree and will abide by the volunteer policies and procedures listed in this agreement.
  4. I agree to make a volunteer commitment of at least three (3) months. I also agree to work a minimum of 5 (five) hours per month to stay active in the program.
  5. I will take ideas, constructive comments, suggestions and criticisms directly to the Volunteer Coordinator.
  6. If communication problems develop between employees or other volunteers and me, I will report these to the Volunteer Coordinator as soon as possible.
  7. Photo authorization: I expressly grant to the BDI, and to its employees, agents, and assigns, the right to reproduce an image of me in connection with the exhibition and publication of media including, but not limited to, live presentations, database records, slide shows, web pages, and print materials.
  8. I understand that my volunteer assignment may be terminated at any time at the discretion of the Volunteer Coordinator or my supervisor.
  9. I agree to abide by any safety rules given me by BDI or the function for which I am volunteering.
  10. I will not possess, use, sell or be under the influence of drugs or alcohol while on BDI property, premises or while volunteering at BDI functions.
  11. As a condition of being a volunteer with BDI, I agree to maintain a high degree of ethical standards and be law abiding in all respects. I am offering my time and services to the BDI purely as a volunteer and without any expectation of payment of any kind. I understand I will not be compensated for such services in any way. I hereby waive any claim for wages for the time and services volunteered by me.
  12. I am at least 18 (eighteen) years of age.
Signature:  
Date:  
   
 

 

OR print and mail the form to:
    Behavioral Diabetes Institute
    P.O. Box 501866
    San Diego, CA 92150-1866

Please call 858-336-8693 if you have any questions.