The Volunteer Acknowledgment Form is a critical document designed to capture essential information about individuals who dedicate their time and skills to support organizational activities without financial remuneration. It includes a comprehensive collection of volunteer details, such as full name, contact information, social security number, demographic data, and specific details relevant to the volunteering activities, for instance, driver’s license and personal auto insurance information where necessary. This form also delineates the scope of work, the duration of the volunteer services, and the expected commitment in terms of hours. Moreover, it outlines the legal framework under which the volunteers operate, highlighting the protections and coverage offered to them under state law, including state sovereign immunity and liability protection, while clearly stating the exclusions like unemployment compensation. The acknowledgment part of the form serves as a formal agreement where volunteers confirm their understanding of the terms and their role, ensuring they are informed about their responsibilities and the legalities of their volunteer status. It emphasizes the importance of adhering to relevant state and federal statutes, university regulations, and policies, underscoring the expectation of acting under the direction of university officials. This form, which requires annual renewal, plays a pivotal role in formalizing the volunteer arrangement, safeguarding both the volunteer's and the organization's interests and ensuring a clear communication channel between both parties.
| Question | Answer |
|---|---|
| Form Name | Volunteer Acknowledgment Form |
| Form Length | 2 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 30 sec |
| Other names | Volunteer_Ackno wledgement_v5 fgcu volunteer form |
VOLUNTEER ACKNOWLEDGMENT FORM
VOLUNTEER INFORMATION
Full Name: __________________________________ Social Security #:_____________________
Gender: ___M ____F |
Date of Birth: _________________ UIN# ____________________ |
Address: __________________________________________________________________________
City: _______________________ State/Province: ________ |
Zip/Postal Code: _______________ |
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Phone: ______________________________ |
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Ethnicity: (select only one): _____ Hispanic or Latino _____ Not Hispanic or Latino |
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Race: (select one or more): |
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_____ American Indian/Alaskan |
_____ American Indian/Alaskan Native |
_____Asian |
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_____ Black/African American |
_____ Native Hawaiian/Other Pacific Islander _____White |
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When applicable to volunteer activities performed, please provide the following information:
Dri er’s Li e se; “tate of Issue a d Nu er __________ ________________________________
Personal Auto Insurance;
Company & Policy # ______________________________________________________________
DEPARTMENTAL AUTHORIZATION
___________________________ has volunteered to assist the _________________________
(PRINT NAME)(DEPARTMENT)
with the following activities:______________________________________________________
___________________________________________________________________ A ti ities
It is expected that Activities will be provided (dates)_______________ to __________________
for approximately ________number of hours |
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daily |
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weekly |
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monthly. |
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Representative: ______________________________Title:__________________________________
Dept Name: _________________________________Dept. Org Code #:_______________________
________________________________________________ |
____________________ |
Departmental Representative Signature |
Date |
Page 1 of 2 |
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Revised December 2009 |
PLEASE READ THIS INFORMATION AND CERTIFY BELOW
Florida Gulf Coast U i ersit U i ersit tha ks ou for do ati g our ti e a d e pertise
volunteering to assist the University for the Activities, Department, and dates listed on the Volunteer Acknowledgement Form (page 1). Please be advised that Florida law authorizes and encourages the University to accept the services of volunteers, and defines a volunteer as any person who, of his or her own free will, provides services with no monetary or material compensation. While acting within the scope of your university activities, as a volunteer you are covered by state sovereign immunity and
lia ilit prote tio i a orda e ith Chapter , Florida “tatutes, a d Worker’s Co pe satio i
accordance with Chapter 440, F.S., excluding the replacement of lost wages. In other words, Volunteers
are considered to be providing services on behalf of the University and are afforded liability coverage a d orker’s o pe satio o erage i the sa e a er as U i ersit e plo ees. Ho e er,
Volunteers are not entitled to unemployment compensation and are not subject to any provisions of law related to state employment. In carrying out your assigned duties and responsibilities, you are expected to report any injury you experience or any threatened claim you may become aware of as a result of your volunteer efforts. You do not have the right to make any contracts or commitments on behalf of the University. You are also expected to comply with applicable state and federal statutes, University regulations, policies and procedures, and to act under the direction of University officials and administrators. This acknowledgment form expires on June 30th of the current fiscal year and must be renewed annually.
CERTIFICATION
I, __________________________________________, hereby acknowledge that I have read and
understand the above information, and that I am acting in the capacity of a volunteer on behalf
University for purposes of the
_____________________________________ |
_______________________ |
Volunteer Signature |
Date |
SUBMIT COMPLETED FORM TO HUMAN RESOURCES
Page 2 of 2
Revised December 2009