Volunteer Application

You will be asked to sign the following agreement during the interview.

I, ______________________, authorize Meals on Wheels London to collect personal information appropriate to the position(s) applied for concerning my employment history as well as any volunteer experience, and to verify the character references I have supplied. I understand that the information obtained will be confidential but will be shared with the appropriate Police Department in order to obtain clearance on a Police Records Check. I understand that my personal information may be used to keep me informed and up to date on the activities of Meals on Wheels London, including services, funding needs and opportunities to volunteer or to give. I hereby certify that my drivers licence and vehicle insurance are valid and that the above information is true to the best of my knowledge. I agree to keep Meals on Wheels London informed if any of the above information changes at any time. I understand that any willful falsification of information may result in termination of my volunteer assignment.

I agree to hold as confidential and will not disclose or release to any person or agency at any time, except where required by law, any information or document that tends to identify anyone receiving Meals on Wheels London services without the written consent of the individual or their guardian prior to the release or disclosure of information or documents. I understand that a breach of client confidentiality may result in my being removed from my volunteer position; and that release of confidential information might be cause for legal action.

Important Note: All information Meals on Wheels London receives about clients is confidential – names, addresses, health conditions, etc. It is NOT considered a violation of confidentiality for volunteers to inform Meals on Wheels London of concerns about clients. Often volunteers are the first persons to recognize that a client is in poor health or has a problem needing attention. Please do not identify clients by name or address to ANYONE other than Meals on Wheels London staff. Thank you for your cooperation.