Volunteer Application Step 1 of 3 - About You 33% Thank you for interest in Girls Embracing Mothers (GEM)! Volunteers are integral to our work in promoting intergenerational healing and empowering girls and their mothers to break the cycle of incarceration. Volunteers may support GEM through a variety of activities including our Pearl and Diamond programming, special events, administrative assistance, and other projects. Please complete the following volunteer application to let us know your interests and to stay informed about upcoming opportunities. All volunteers must complete a background check and a short volunteer training to work with minor children in our program. Justice-impacted volunteers are encouraged to apply. Personal InformationName* First Last Email* Cell Phone*Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Date of Birth*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Drivers License Number* Drivers License State* T-Shirt Size*SmallMediumLargeXLarge2XLOccupation What inspired your interest in volunteering with Girls Embracing Mothers? Please list any allergies or special health concerns that we may need to be aware:Emergency Contact InformationEmergency Contact Name* First Last Emergency Contact Relationship* Emergency Contact Phone* Areas of Interest* Pearl Program - prison visits between mothers and daughters Ruby Program -prison visits with mothers and re-entry dinners Diamond Program - girl empowerment workshops throughout the year Summer Camp - four day (overnight) camp in June #amplifyHER - annual conference in October Holiday Giving Event in December Please describe any special training, skills, hobbies(include additional information such as any professional licenses or certificates, other languages spoken etc)Pearl Visitation RequirementsIf you are interested in joining us inside prison facilities for our Pearl programming with mothers and daughters and have, yourself, been previously incarcerated, please provide the following additional information: State of conviction and incarceration Last Sentence Date MM slash DD slash YYYY Volunteer Agreement I hereby agree to accept a position in a voluntary capacity as a volunteer for Girls Embracing Mothers (herein after referred to as GEM). I understand that the term VOLUNTARY means the way in which actions or services are rendered to GEM. Such actions or services are rendered to GEM with generous and charitable motives without any employment type benefits. No liability whatsoever will be incurred by GEM to anyone who performs voluntary actions or services. I shall hold as absolutely confidential all information that I may obtain directly or indirectly concerning girls, their families and/or other GEM representatives and not seek to obtain confidential information from a girl. I promise to maintain the confidentiality of such information and understand that unauthorized access to such information or release of such information will result in an immediate termination of my volunteer services. I understand this confidentiality agreement continues even after I no longer volunteer with GEM. I fully understand and agree to assume all risks involved in any and all duties that I perform for GEM. I agree to attend a mandatory GEM volunteer orientation and familiarize myself with GEM policies and procedures. I will fully comply with both the letter and the spirit of these procedures. I understand that a criminal background check will be conducted and that I may be asked to provide additional information related to any arrests and/or convictions. I understand that public relations are an important part of volunteering at GEM. I agree, therefore, on behalf of myself, my heirs, personal representatives, and executors to allow GEM to use any photograph or video recording taken of me for use in public relations efforts. I will not, under any condition, serve as a GEM volunteer while under the influence of drugs, alcohol or any other substance. I fully understand that GEM expects high standards of moral and ethical treatment of the girls in its care. I agree to strictly adhere to these standards in my voluntary capacity at GEM. I fully understand and agree that either for failure to fully comply with any and all of the obligations outlined in this volunteer agreement, or for any reason whatsoever, while performing my voluntary services to GEM in a voluntary capacity, GEM at its sole discretion, may immediately terminate my volunteer services. Release I agree to release, discharge, indemnify and hold Girls Embracing Mothers, Inc. (GEM) harmless for any and all damage to my personal property while performing as a VOLUNTEER in a VOLUNTEER CAPACITY any and all duties for GEM. I agree that any written or oral misrepresentation in making this application is just cause for dismissal. Agreement* I ACKNOWLEDGE THAT I HAVE READ AND UNDERSTOOD THE TERMS AND CONDITIONS OF THE FORGOING VOLUNTEER AGREEMENT AND RELEASE AND THAT I WILL COMPLY WITH THE SAME. Applicant Electronic Signature* Please type your First and Last NameEmailThis field is for validation purposes and should be left unchanged.
