Page 1

Personal Information








Contact Information






Leave blank if you do not have an alternate email

Please do not text me at this number.

Social Media


Connection to Donation











Volunteer Programs

Page 2

VOLUNTEER CONFIDENTIALITY AGREEMENT

As a Volunteer with Gift of Hope Organ & Tissue Donor Network, a non-profit organization involved in organ and tissue donation, I agree to the following:

  1. While serving as a Gift of Hope Volunteer, I will act in a respectful and professional manner.
  2. Gift of Hope is thankful for my services to the community, but I am not a Gift of Hope employee. I am donating my services to the community and I am not entitled to pay, or any benefits provided to Gift of Hope employees.
  3. I will complete all required training and follow the direction of my Volunteer supervisor(s).
  4. If I do something outside the scope of my Volunteer duties, or in a manner that violates my training or Gift of Hope policies, I may be personally liable for any injuries to others or damage to property that results.
  5. Gift of Hope is a charitable organization and honors donors and donor families by being a good steward of its resources. I will not use Gift of Hope resources in any way that is wasteful, or violates my training or Gift of Hope policies.
  6. Gift of Hope will indemnify, hold harmless and defend me, from and against all liability, claims, actions, damages, losses, and expenses, including, but not limited to, attorney’s fees and costs, arising out of my performance of my Volunteer duties if all of the following are true: 1) I performed the services at the request of Gift of Hope; 2) I performed the services in good faith and in accordance with my training; 3) I was not grossly negligent in the performance of the services; and 4) I promptly informed Gift of Hope as soon as I became aware of the problem.
  7. If I am injured while I am providing Volunteer services, my exclusive remedies are those available under Workers Compensation.
  8. 8.As a condition of volunteering, I give permission for Gift of Hope to conduct a background check on me, which may include a review of sex offender registries, child abuse, and criminal activity records. I understand that Gift of Hope may terminate my Volunteer position at any time, for any or no reason.
  9. 9.I transfer title to and authorize Gift of Hope and its employees, agents, successors and assigns to use, disclose, publish, post or otherwise disseminate, my name, photograph, likeness, words, voice and/or personal data and any digital data generated during my Volunteer services by myself or others (e.g., photo, videos, audio, etc.) in any way Gift of Hope deems appropriate. I release Gift of Hope and its employees, agents, successors and assigns from any and all liability related to the same.
  10. While providing Volunteer services, I may have access to sensitive, confidential, personal or proprietary information of Gift of Hope, its employees and agents, donors, donor families, recipients, healthcare providers, and other community members (“Sensitive Information”). I agree that I will not use or disclose any Sensitive Information that I access or receive during my Volunteer service. I will immediately notify Gift of Hope of any concerns or problems.
I acknowledge that I have read and fully understand and agree to the entirety of this Agreement and that no oral representatives, statements or inducements apart from this release have been made to me.

Page 3

AMBASSADORS FOR HOPE PROGRAM
Anti-Harassment Policy

All Ambassadors have the right to work in an environment free from harassment. Gift of Hope’s Anti-Harassment policy applies to all volunteers involved in Gift of Hope’s Ambassadors for Hope Program.

Gift of Hope is committed to providing an environment free from harassment. Harassment against any individual based on race, color, religion, sex, national origin, citizenship status (with regard to employment), ancestry, age (40 and over), order of protection status, marital status, familial status (with regard to housing), physical or mental disability, arrest record, military status, sexual orientation, gender identity, or unfavorable discharge from military service is expressly prohibited. Gift of Hope strictly prohibits any offensive or unwelcome physical, written or spoken conduct based on any of these protected characteristics. Harassment includes, but is not limited to, offensive jokes, slurs and other uninvited verbal, graphic, visual or physical conduct by one individual toward another.

While this policy prohibits all forms of harassment, sexual harassment, in particular, includes unwelcome sexual advances or requests for sexual favors or acts, unwanted touching or intimacy, insulting or degrading sexual remarks or epithets, slurs or negative stereotyping based on gender and the posting or display of sexually offensive or degrading materials in the workplace.

Harassment can include, but is not limited to, the conduct of a volunteer toward another volunteer, a volunteer toward a Gift of Hope employee, a Gift of Hope employee toward a volunteer, a volunteer toward a non-Gift of Hope employee (e.g., members of the public), or a non-Gift of Hope employee toward a volunteer.

No Gift of Hope Ambassador is permitted to engage in any form of harassment. Gift of Hope Ambassadors are personally liable for harassment that they commit.

Complaint Resolution Procedure

All complaints of harassment are serious and an appropriate investigation of complaints will be conducted. If you believe you have been the subject of any form of harassment or other offensive or inappropriate conduct, tell the individual(s) that the conduct is unwelcome and immediately bring it to the attention of Gift of Hope’s Human Resources Department by calling: 630-758-2648, or sending an email to: humanresources@giftofhope.org. This is the appropriate and required course. All Ambassadors are encouraged to raise questions that they may have regarding these issues directly with Human Resources. There will be no retaliation or reprisals of any kind against anyone who has, in good faith, raised any concern about any form of harassment.

The very nature of harassment may make it virtually impossible to detect unless the individual being harassed registers a complaint with Human Resources. Consequently, in order for Gift of Hope to deal effectively with these problems, you must report the offensive conduct or situation at the earliest possible time. Regardless of who receives the initial report, the matter will be promptly addressed and handled as appropriate.

If it is determined that a confidential investigation is necessary due to the nature of the allegations, information regarding the investigation will be kept confidential to the extent possible; however, confidentiality cannot be guaranteed.

Anti-Retaliation

Registering a good faith complaint will in no way be used against the complaining Ambassador, and retaliation in any manner against anyone who makes a good faith report of harassment is strictly prohibited. If you believe you have suffered retaliation for a good faith report or you have knowledge that another volunteer or employee has suffered retaliation for a good faith report, you should immediately bring this to the attention of Human Resources.

Disciplinary Action

Any Ambassador who is found to have violated this policy will be subject to appropriate disciplinary action, up to and including dismissal from the Ambassadors for Hope Program.

I acknowledge that I have read, fully understand, and agree to abide by Ambassadors for Hope Program’s Confidentiality and Anti-Harassment Policy.



Contact Information