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OUR MISSION: To provide services and supports to people with barriers to attain self-direction, inclusion, personal fulfillment, and productivity in all life areas.

 

Online Volunteer Application

Instructions for Applicant

*To print an application:  Download

Internal Use
Current Opportunities
Personal Information

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Employment
Emergency Contact

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Preferences & Skills
  1. Please check any of the following DSI Volunteer areas that are of interest.
  2. Please check any of the following DSI Volunteer areas that are of interest.
Availability

Please fill in the appropriate times that apply to your schedule.

Agency/Volunteer Agreement

This agreement is intended to indicate the seriousness in which we treat our volunteers. The intent of the agreement is to assure us both of our deep appreciation for your services and to indicate our commitment to do the very best we can to make your volunteer experience a productive and rewarding one.

  1. Agency

    We, Developmental Services, Inc. (agency), agree to accept the services of [firstname lastname] (volunteer) beginning [date], and we commit to the following:

    • To provide adequate information, training, and assistance for the volunteer to be able to meet the responsibilities of their position.
    • To ensure diligent supervisory aid to the volunteer and to provide feedback on their performance.
    • To respect the skills, dignity, and individual needs of the volunteer, and to do our best to adjust to these individual requirements.
    • To be receptive to any comments from the volunteer regarding ways in which we might mutually better accomplish our respective tasks.
    • To treat the volunteer as an equal partner with agency staff and to be jointly responsible for accomplishment of the agency mission.
  2. Volunteer

    I, [firstname lastname], Agree to serve as a volunteer for Developmental Services, Inc. and commit to the following:

    • To perform my volunteer duties to the best of my abilities.
    • To adhere to agency rules and procedures, including recordkeeping requirements and confidentiality of agency and client information.
    • To meet time and duty commitments, or to provide adequate notice so that alternate arrangements can be made.
    • To act at all times as a member of the team responsible for accomplishing the mission of the agency.
  3. Agreed to:
Volunteer Release of Liability

I, for myself and my heirs, executors, administrators and assigns, hereby release, indemnify and hold harmless DSI, Bartholomew County, and the City of Columbus from all liability for any and all risk of damage or bodily injury or death that may occur to me (including any injury caused by negligence), in connection with any volunteer opportunities through DSI in which I participate.  I likewise hold harmless from liability any person transporting me to or from any DSI activities.  In addition,  DSI officials have permission to utilize any photographs or videos taken of me for publicity or training purposes.  I will abide by all safety instruction and information provided to me during all DSI activities.

Further, I expressly agree that this release, waiver, and indemnity agreement is intended to be as broad and inclusive as permitted by the State of Indiana, and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect.

I have no known physical or mental condition that would impair my capability to participate fully as intended or expected of me.

I have carefully read the forgoing release and indemnification and understand the contents thereof and sign this release as my own free act.

Parental Consent

In order for your child to become a volunteer with our organization, we need your consent and your involvement in helping them have a productive experience.  Please read and sign below.

Name of Agency: Developmental Services, Inc.

Name of Youth Volunteer: [firstname lastname]

I understand that my child named above wishes to be considered for a volunteer opportunity at DSI and I hereby give my permission for them to serve in this capacity, if accepted by the agency. I understand that they will be provided with orientation and necessary training for the safe and responsible performance of their duties and that they will be expected to meet all the requirements of the position, including regular attendance and adhere to agency policies and procedures.  I understand that they will not receive monetary compensation for services contributed.

Volunteer Confidentiality

As an acting employee for DSI, your responsibility with regard to confidentiality extends even beyond your working hours.  Failure to bide by the agency’s confidentiality code, even if it is inadvertent, can cause serious emotional injury and loss of opportunity to those who have placed their trust in us.

Please remember the following:

  • Refrain from using last names of clients when discussing them in public or in casual areas of the building such as bathrooms and hallways.
  • Provide file access to only those with proper authority who need to promote the clients best interest.
  • Do not release any client/staff information without written consent.  This includes giving a client’s photo to anyone or permitting anyone to photograph the individual without written consent.
  • Each client must be given the opportunity to decline being present during site tours or any other situation where the public is visiting and confidentiality for that individual is in jeopardy.
  • Please do not specify names of companies who are associated with DSI (pertaining to either job placement or work contract for example) when discussing volunteering in public.  This could jeopardize the contract, bidding procedure, and an individual’s employment.

I hereby agree to this confidentiality agreement:

Authorization to Release Information

I HEREBY AUTHORIZE THE INDIANA BUREAU OF MOTOR VEHICLES TO RELEASE ANY AND ALL INFORMATION ON FILE REGARDING:

MY PERSONAL VEHICLE INSURANCE COVERAGE IS WITH:

In addition, I authorize Developmental Services, Inc. to request a Limited Adult Criminal History..