Please check all applicable.
We will need your license number, state issued, and expiration date when we call you as a follow up to your application.
If yes, we'll ask you about it when we follow up on your application
Include name, address, and phone number.
Thank you for your interest in being a volunteer for Island Connections. As you transport our neighbors, you may have moral and legal responsibilities to provide proper, adequate, safe care which includes maintaining confidentiality. Everything that is written and spoken is considered confidential. Our neighbors have a right to as much privacy as we can provide. This includes choosing a private place to talk (if necessary) and always treating neighbors with dignity and respect.
You understand that when you use your personal automobile you will maintain automobile liability insurance equal to or greater than the minimum required by the State.
Please sign below affirming that the above information is true and accurate and giving Island Connections the right to contact all references you have provided as well as perform a background check on you.
By signing, you are also agreeing that any misrepresentation by you on this application will be sufficient cause for cancellation of your volunteer relationship with Island Connections, and you are releasing Island Connections and its Directors from seeking any and all information about you.
You also understand that if you are unable to perform your volunteer duties without risk to yourself or others, an offer of volunteer opportunity may be withdrawn.
PLEASE NOTE THAT BEFORE YOU BECOME AN ACTIVE DRIVER FOR ISLAND CONNECTIONS: We require a copy of your current driver’s license and insurance card prior to assignment of your 1st ride. Updated records must be provided when expired.
You are signing a pledge that makes confidentiality your responsibility. Please honor that pledge.