Volunteer Application

Thank you for your interest in helping Oregon's children become confident readers and productive citizens. Your gift of time benefits local children and the community-at-large. Please click here if you would like to donate $15 or more to reduce SMART's administrative costs by covering the cost of your background check.

* Required Information
Are you a MINOR under 18 years of age?*
Date*
Legal First Name*
Middle Name
Legal Last Name*
Former Surnames Used
Preferred First Name
Gender*


Birth Date* / /   Example: MM / DD / YYYY
Mailing Address*    Address Type*
City*
State*
County*
Zip*
Home Phone* - -   Example: 503-123-4567
Mobile Phone - -   Example: 503-123-4567
Email*
Yes! I would like to receive SMART eNews.
  Volunteer info only.
Employer
Work Phone - -   Example: 503-123-4567
Emergency Contact Name
Emergency Contact Relationship
Emergency Contact Phone - -   Example: 503-123-4567
What volunteer opportunities are you interested in?*
Click here for descriptions
What are your skills and interests?
In which county would you like to volunteer?* Click here to find a school near you.

Volunteer location preference*

 

Note: Volunteers are scheduled on a first come, first served basis. We accommodate your preferences whenever possible. For scheduling assistance, contact your your local SMART representative.



 

First School Preference
Second School Preference
Third School Preference


Preferred day(s) Monday Tuesday Wednesday Thursday Friday
Preferred time(s) Early Morning Mid-morning Afternoon
 

Scheduling questions? Contact your local SMART office.

Do you read in another language? no yes — If yes, please specify  
How did you hear about SMART?
Were you a SMART student? School   Years
Do you know someone interested in volunteering with SMART? Name  
Phone   - -  Example: 503-123-4567
Email  
Additional Comments:

National Criminal Background Check

To ensure the safety of the children, all volunteer applicants 18 and older must complete this section before the application can be processed. Your cooperation is greatly appreciated.
Have you EVER been convicted of a crime other than a minor traffic violation?*

Authorization and Release

All applicants must read and agree below. I agree not to publish or disclose to anyone outside of SMART any confidential or business information or material from SMART, either before, during, or after employment with SMART, except with SMART’s written permission.

I agree to conform to the instructions, rules, and policies outlined in the SMART Volunteer Policy & Procedure Guide and my position description. I understand that either the volunteer or the organization may at any time, for whatever reason, discontinue the volunteer service relationship.

I understand that as part of the volunteer application process, SMART and the entities it serves (Host Sites) may conduct a background check which could include a criminal background check on me. I hereby authorize SMART and any of its Host Sites to conduct a criminal background check on me and to communicate the results of the criminal background check to SMART. I understand that the criminal background check may be conducted by any one or more methods, including without limitation, using government and private databases and services. I understand that a criminal background check may be undertaken at any time, and may be repeated from time-to-time, while I am associated with SMART.

I hereby release and hold harmless SMART, its Host Sites and their respective employees and agents from any and all liability whatsoever arising from or relating in any way to: any person or entity conducting the criminal background check; the disclosure of information resulting from the criminal background check; and any action which may be taken by any individual or entity based upon that information.

I understand that a misdemeanor will not necessarily bar me from serving as a SMART volunteer, but it will be reported to the school principal or Host Site for volunteer authorization. I understand that a felony conviction will prohibit my participation as a SMART volunteer.

I have read and understand and commit to the terms stated above. I declare that my answers and all statements made by me herein are true and correct.*

Yes, SMART may use images of me, captured during reading sessions or related activities, to be used solely for the purposes of SMART promotional material and public relations including its websites.

SMART is an equal opportunity employer and does not discriminate on the basis of sex, sexual orientation, age, race, color, religion, marital status, national origin, disability, veteran, or other protected status.