Volunteer Form

Name*

First Last

Organization/Business Name

Email*

Address*

Street Address Address Line 2 City State ZIP Code

Phone*

Location of interest*

Gender

Female
Male

Click which one that applies to you*

Adult Volunteer
College Volunteer
Youth Volunteer (under 18 years of age)

Emergency Contact*

First Last

Emergency Contact Phone:*

Areas of interested*

Volunteering in one of your facilities
Volunteering during a special event
Help organize a needs drive
Corporate Sponsorships

Group or Individual Volunteering?*

Group
Individual

How many people will be in your group?

What type of volunteer commitment is right for you?*

A one time event
About once a month
A few times a month
About once a week
A few days per week
More than a few days per week

What is your availability? Check all that apply.*

Weekdays - 9:00 a.m. - 3:00 p.m.
Weekdays - 3:00 p.m. - 7:00 p.m.
Saturdays - 9:00 a.m - 5:00 p.m.
Sundays - 9:00 a.m - 5:00 p.m.

Are you fullfilling a volunteer, shadow or community service requirement?*

Yes
No

How many hours are you required to complete?

Date required to be completed:

What activities would you like to do as a volunteer with Canopy?*

Arts & Crafts
Sports & Fitness
Life Skills/Independent Living
Mentoring
Tutoring
Motivational Talks
Play board or card games
Campus beautification
Read to our children

What skills or talents do you feel best prepare you to volunteer with Canopy?

How did you hear about Canopy?

Name of Employee or Volunteer Referring Canopy:

I would like to sign up for Canopy enewsletter and email updates.

Yes
No

Background Check Consent*

Please check to agree to below statement

I acknowledge that volunteer roles are contingent upon clear results of a background check through the Central Registry Application.

Confidentiality Agreement & Photo Release*

Please check to agree to Confidentiality Agreement & Photo Release

Confidentiality Agreement & Photo Release:

I understand and agree that in the performance of my duties as a volunteer of Canopy Children’s Solutions (Canopy) I must hold in strictest confidence any observations I may make or information I may hear regarding patients, patient families or staff.

I verify that the information provided by me on this application is true, correct and complete. I attest that I haven't ever been charged with any crime and grant Canopy permission to verify this information in arriving at a decision.

I understand that any false or misleading statements or the omission of any information necessary to make this application complete will result in refection of my application or termination of my service.

Additionally, Canopy has my consent to photograph, video tape, or audio tape me performing my volunteer duties. I understand that these may be used toward the advancement of public education, the promotion of Canopy, and/or any other legitimate purpose.

I understand that upon my successful completion of the volunteer placement processes required at Canopy, I will become a volunteer. As a volunteer, I acknowledge that I will not receive compensation for services.

HANDBOOK ACKNOWLEDGMENT*

I acknowledge that I have read, understood and agree with the below Canopy Volunteer Handbook

CANOPY VOLUNTEER HANDBOOK

Canopy greatly appreciates the time and talent that volunteers bring to the Organization, and we pledge to respect your rights at all times.

VOLUNTEER RIGHTS
▪ To do meaningful and satisfying work.
▪ To be carefully assigned to project which meet your interests, skills, qualifications and needs.
▪ To be oriented to the Organization- its mission, goals, staff, activities, and policies.
▪ To be trained appropriately for your work.
▪ To receive supervision and guidance throughout your volunteering experience, as well as regular and constructive feedback and performance.
▪ To show initiative and leadership.
▪ To make mistakes and learn from them.
▪ procedures.
▪ To be treated like a co-worker.
▪ To be included in appropriate meetings, training sessions, and social functions.
▪ To have your service hours documented in letter or certificate upon request.
▪ To be free from discrimination on grounds of age, gender, marital status, race, sexuality, religion and disability.

VOLUNTEER RESPONSIBILITIES
▪ To be reliable and carry out work to the best of your ability in a way that corresponds to the mission, goals, values, and ethics of Canopy.
▪ To be open and honest with Canopy about your expectations and abilities.
▪ To fully participate in the interview, orientation, training and evaluation processes.
▪ To provide timely and constructive feedback to Canopy.
▪ To maintain confidentiality and privacy with regards to Organization information, youth/children, and staff.
▪ To show respect to staff members, other volunteers, and the people we serve.
▪ To acknowledge decisions made by staff members of the Board of Directors on behalf of the organization.
▪ To fulfill time and task commitments.
▪ To inform your supervisor in a timely manner if unable to fulfill commitments.
▪ To accurately record volunteer hours on a weekly basis.
▪ To be an Ambassador of Good Will and represent Canopy in the community.

VOLUNTEER POLICIES AND PROCEDURES

EQUAL OPPORTUNITY
It is the policy of Canopy to provide equal opportunity to all volunteers, and employees in accordance with applicable laws, directives, and regulations of federal, state and local governing bodies and agencies.

Canopy will not discriminate against volunteers because of race, color, religion, national origin, gender, sexuality, disability, age, marital status, or status with regard to public assistance.

HARASSMENT
All volunteers and employees will be treated with respect and dignity.

STATEMENT OF PRINCIPLES
▪ Everyone is entitled to a respectful workplace environment.
Sexual harassment and harassment that is based on color, religion, national origin, gender, sexuality, disability, age and marital status is prohibited.
▪ Each volunteer and employee has responsibility for preventing harassment and maintaining a respectful workplace.
▪ Retaliation against volunteers for opposing harassment, for reporting an incident of suspected harassment, or for participating in the investigation or
▪ No employee or volunteer regardless of position has the right to violate any of these principles.

USE OF ALCOHOL, DRUGS, AND OTHER INTOXICANTS

The use, possession, distribution and sale of alcohol, illegal drugs, or other intoxicants by volunteers is strictly prohibited at all Canopy facilities and at any time volunteers are on duty or in the presence of people served by Canopy. Volunteers are required to report for duty in sober and reliable state, free of the influence of alcoholic beverages, illegal drugs, or other intoxicants. Volunteers are not to use any such intoxicants while on duty, or at any time when entrusted with the care of the people served by Canopy. Whether or not a volunteer is on duty, consumption or possession of alcoholic beverages, illegal drugs, or other intoxicants is not allowed on Canopy premises or facilities or on any outing where people served by Canopy are in attendance.

CONFIDENTIALITY OF CHILDREN INFORMATION

Canopy regards the confidentiality of its records and those of the people served by Canopy as essential to the provision of services. Volunteers are responsible for assuring that all records and information remain confidential in accordance with all applicable state and federal statutes, rules and regulations. Sharing the identity of anyone receiving services from Canopy is prohibited. No information, including taking photographs, regarding a child may be shared with anyone outside Canopy and information shared within Canopy should be on a need-to-know basis only.

Canopy’s reputation is a valuable asset. Disclosure of confidential or proprietary information, or the spreading of libelous and malicious information about persons served by Canopy, its facilities or programs, other volunteers, employees, or services, may result in no further volunteer opportunities for that individual.

RELATIONSHIP BETWEEN CHILDREN AND VOLUNTEERS

For the safety and well-being of our children, staff, and volunteers, it is important that professional boundaries between our children and volunteers be maintained. These boundaries ensure that focus remains on the children and allows Canopy to provide the best service possible.
▪ When answering the phone, use your first name only.
▪ Do not share personal contact information, such as email address, phone number or home address with the children.
▪ Do not accept gifts or money from or lend personal items or money to children.
▪ Do not be afraid to gently say no to a child if he or she expresses interest in a relationship other than professional one. Explain that your work should focus on the person you are helping while they are in the Canopy program.
▪ If a child crosses any of these boundaries, contact your supervisor so that staff can address the issue with the children.

MEDIA POLICY
▪ It is imperative that all public statements to the media (including, for example, newspapers, radio, television, public forums where media may be present, program specifics presentations, speeches, panels and film) are consistent with and accurately reflect the mission of Canopy. The Board of Directors has vested the right in the CEO to make all public statements concerning Canopy policies, beliefs, missions, or role of the organization.
▪ Any volunteers may, and are encouraged to, maximize the visibility and image of Canopy in a manner consistent with the recognized mission and agenda of the organization, and to educate the public and bring out a better understanding of the mission and ongoing work of Canopy while carrying out the responsibilities of their positions and job descriptions.
▪ Any unauthorized statements or statements that discredit the mission and role of Canopy or deviate from this policy shall result in no further volunteer opportunities for the individual or organization.

CONFLICT OF INTEREST POLICY

The conflict of interest policy is designed to help directors, officers, volunteers, and employees of Canopy identify situations that present potential conflicts of interest and to provide Canopy with a procedure which, if observed, will allow a transaction to be treated as valid and binding even though a director, officer, volunteer or employee has or may have conflict of interest with respect to the transaction. The policy is intended to comply with the procedure described within the Mississippi Code governing conflicts of interest for directors of nonprofits corporations. In the event there is inconsistency between requirements and procedures described herein and those in the statute, the statute shall control.

1. Conflict of Interest Defined - For purposes of this policy, the following circumstances shall be deemed to create Conflicts of Interest:

Outside Interests
▪ A Contract or Transaction between Canopy and a Responsible Person or Family Member.
▪ A Contract or Transaction between Canopy and an entity in which Responsible Person or Family Member has a Material Financial Interest or of which such person is a director, officer, agent, partner, associate, trustee, personal representative, receiver, guardian, custodian, conservator, or legal representative.

Outside Activities
▪ A Responsible Person competing with Canopy in the rendering of services or any other Contract or Transaction with a third party.
▪ Responsible Persons having Material Financial Interest in, or serving as a director, officer, agent, partner, associate, trustee, personal representative, receiver, guardian, custodian, conservator, or legal representative of, or consultant to an entity or individual that competes with Canopy in the provision of services or in any other Contract or Transaction with a third party.

Gifts, Gratuities, and Entertainment
▪ A Responsible Person accepting gifts, entertainment, or other favors beyond that of minimal value from any individual or entity that:
▪ Does or is seeking to do business with, or is a competitor of Canopy; or
▪ Has received, is receiving, or is seeking to receive a loan or grant, or to secure other financial commitments from Canopy;
▪ Is a charitable organization operating is Mississippi where does this come from? Why?
▪ Under circumstances where it might be referred that such an action is intended to influence or possibly would influence the Responsible Person in the performance of his or her duties. This does not preclude the acceptance of items of nominal or insignificant value or entertainment of nominal or insignificant values which are not related to any particular transaction or activity of Canopy.

2. Definitions
▪ A “Conflict of Interest” is any circumstance described in Part 1 of this section.
▪ A “Responsible Person” is any person serving as an officer, employee, volunteer, or member of the Board of Directors of Canopy.
▪ A “Family Member” is a spouse, domestic partner, parent, child or spouse of a child, brother, sister, or spouse of a brother or sister of a Responsible Person.
▪ A “Material Financial Interest” in an entity is a financial interest of any kind, which, in view of all circumstances, is substantial enough that it would or reasonably could, affect a Responsible Person’s or Family Member’s judgment with respect to transactions to which the entity is a party. This includes all forms of compensation.
▪ A “Contract of Transaction” is any agreement or relationship involving the sale or purchase of goods, services, or rights of any kinds, the providing or receipt of a loan or grant, the establishment of any other type of pecuniary relationship, or review of a charitable organization by Canopy. The making of a gift to Canopy is not a Contract or Transaction.

3. Confidentiality – Each Responsible Person shall exercise care not to disclose confidential information acquired in connection with status or information the disclosure of which might be adverse to the interests of Canopy. Furthermore, a Responsible Person shall not disclose or use information relating to the business of Canopy for the personal profit or advantage of the Responsible Person or a Family Member.

4. Review of Policy – Each new Responsible Person shall be required to review a copy of this policy and to acknowledge in writing that he or she had done so.

GRIEVANCE POLICY

Canopy believes volunteers have the right to express grievances, concerns or dissatisfaction associated with a volunteer position or with staff members. We are committed to providing a fair and equitable process for dealing with issues that impact volunteers and we pledge to make every reasonable effort to resolve grievances.

Volunteers who have a grievance should first attempt to resolve that grievance with the individual responsible. If that person does not respond, the volunteer should register a compliant with the supervisor. The supervisor will meet the volunteer to discuss the grievance and propose a solution. The meeting will be documented and reported to the Human Resources Department.

If a resolution is not achieved with the supervisor, of if the volunteer has a grievance with the supervisor then the volunteer should contact Volunteer Coordinator. The Volunteer Coordinator will make the final determination as to whether or not the issue is a serious problem and what resolution is possible. All parties will be expected to faithfully adhere to the resolution reached at this meeting. A report of this meeting will also be filed with Human Resources Department and in the Volunteer Program files.

RECORDKEEPING

Canopy compiles the hours donated by volunteers. Volunteer hours are published and reported to foundations for funding purposes. It is important that all volunteers record the hours they work at the time they incurred. A sign-in sheet is provided by your Supervisor. If you are not working in an office, then an accounting of hours should be submitted to development@mycanopy.org.

CONCLUSION OF POSITION

Canopy accepts the services of all volunteers with the understanding that such service is at the sole discretion of Canopy. Canopy reserves the right to conclude a volunteer’s assignment if services are no longer needed or if there has been a violation of Canopy policy. The volunteer may at any time, for whatever reason, decide to conclude the volunteer’s relationship with Canopy. Notice of such a decision should be communicated as soon as possible to the supervisor.

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