Volunteer with SFMD

APPLICANT INFORMATION

Applicant Name

Email Address*

Phone Number

Phone Type
MobileHome

Home Address

Street Address

City

Zip Code

Date of Birth (Volunteers must be at least 18 years of age):

Education Level (Select the last year completed):
Grade 9Grade 10Grade 11Grade 12GEDCollege - 1 YearCollege - 2 YearsCollege - 3 YearsCollege - 4+ Years

Other education:

Special training, skills, or interests:

Do you currently work or go to school?
No Work or SchoolWorkSchoolBoth Work and School

If you work or attend school, where and for how many hours each week?

What days and times are you available to volunteer?

Volunteer Interests with SFMD - See the Volunteer Information Flyer for descriptions (Choose all that apply):
Administrative ServicesCommunity ServicesDistrict Services

If you have previous volunteer experience, please describe it:

Restrictions that might/will affect your availability for volunteer work:

Have you ever worked or volunteered for the Superstition Fire & Medical District?
YesNo

If yes, please list the dates and what type of work you did:

Other information you would like us to know:

CRIMINAL CONVICTIONS/TRAFFIC VIOLATIONS

Have you ever been convicted of a misdemeanor, gross misdemeanor, or felony (excluding juvenile adjudication)?
YesNo

Have you ever been convicted of a movie traffic violation within the last five years?
YesNo

If you answered yes to either or both conviction questions, please list the date(s), time(s), location(s), circumstance(s), and dollar amount of fine(s). Include any condition of your parole and/or probation, if applicable. Moving traffic violations will only be considered if driving a vehicle is a job requirement. A criminal conviction does not disqualify the applicant, as each case is considered on its individual merits. THE LACK OF REQUESTED INFORMATION IS BASIS FOR REJECTING AN APPLICATION.

READ CAREFULLY BEFORE ACCEPTING AND SUBMITTING

I certify that the information given by me in this volunteer application is true and complete and I understand and agree that the application process or my relationship with SFMD may be immediately discontinued if misrepresentations, falsified statements, or material omissions are found to have been made.

I understand that this application is only valid for the volunteer position applied for at present, and that the Superstition Fire & Medical District is not obligated to retain or consider this application for further openings.

I understand that my volunteer relationship with SFMD is contingent upon satisfactory results of criminal background check utilizing fingerprint analysis and motor vehicle report.

In order to ensure a drug-free work environment, the SFMD prohibits the use, sale, transfer, being under the influence and/or reporting to duty after using or ingesting drugs. Under SFMD policy, alcohol is included within the meaning and prohibition of drugs.

Discrimination of any kind, or harassment of any kind including sexual harassment, whether intentional or not, is prohibited and will not be tolerated.

The SFMD has a strong commitment to its volunteers to provide a safe, healthy and secure work environment. While the SFMD has no intention of intruding into the private lives of its volunteers, it requires all volunteers to report to work without possessing weapons and to perform their duties without violence or threats toward any other individual. I understand that violence or threats will not be tolerated.

I understand that my volunteer service is in no way an offer of or employment and that I shall not receive, nor be entitled to receive, any compensation, reimbursement, or remuneration for my participation in volunteer service. I agree to release the SFMD from any and all claims to compensation, reimbursement, or remuneration related to my volunteer service. I also understand and agree that at no time will I be considered or deemed to be an agent, servant, or employee of the Superstition Fire & Medical District.

I understand that during volunteer service, I may have access to, or may observe, certain information that is confidential or proprietary to the SFMD and I hereby agree not to disclose, discuss, or reveal any such information and to keep any information, records, or files confidential.

I understand that if I receive an identification badge, it will remain the property of the SFMD and be used solely for identification purposes. I understand that I may not use the ID badge to represent myself as an employee or agent of the SFMD other than that which is indicated on the badge.

I have read the above, understand its content, and meaning, and agree to all of its provisions.

Please leave this field empty.

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