In the event of an emergency, the following person is authorized to act on my behalf:

I hereby acknowledge that I have received a copy of Sound Generations’ written Anti-Harassment Policy.  I understand that Sound Generations affirms this policy and declares harassment and related retaliation unacceptable, and considers violations of this policy to be conduct subject to disciplinary review and action, up to and including volunteer termination, or expulsion from the center/program. 

I hereby acknowledge that I have received a copy of Sound Generations’ written Drug and Alcohol Policy.  I understand that Sound Generations affirms this policy and declares intoxication and/or the abuse of substances to be unacceptable while volunteering, and considers violations of this policy to be conduct subject to disciplinary review and action, up to and including volunteer termination, or expulsion from the center/program.

I hereby acknowledge that I have received a copy of Sound Generations’ written Confidentiality Policy.  I understand that Sound Generations affirms this policy and declares the disclosure of client, volunteer, or staff information to unauthorized persons to be unacceptable, and considers violations of this policy to be conduct subject to disciplinary review and action, up to and including volunteer termination, expulsion from the center/program, or possible legal action.   I understand that the duty to maintain confidentiality survives the termination of my service with Sound Generations.

I hereby acknowledge that I have received a copy of Sound Generations’ written Conflict of Interest Policy.  I understand that Sound Generations affirms this policy and declares the exploitation of this position for personal gains or compensation to be unacceptable, and considers violations of this policy to be conduct subject to disciplinary review and action, up to and including volunteer termination, or expulsion from the center/program.  

I hereby acknowledge that I have received a copy of Sound Generations’ written Mandatory Reporting Policy. I understand that as a Sound Generations volunteer I am considered a passive reporter.  This means that I will not face legal action for failing to report the witnessed or suspected abuse or exploitation of a vulnerable adult, but if I choose to I may contact DSHS and make an anonymous report.  If it is safe to do so, I will make a reasonable effort to communicate with a Sound Generations staff member if I witness or suspect the abuse or exploitation of a vulnerable adult.

Sound Generations would like to send you updates about the work we do in our community to support people on their aging journey through community connections and accessible services. Please indicate if you would like to receive these updates.

I give full permission for Sound Generations to use volunteer- related images of me that appear in videos, printed materials, audio recordings, and/or quotes from my interviews/conversations with the Released Parties’ staff, donors, partners, and volunteers without compensation or further authorization.  This may include, but is not limited to, print broadcast, social media, electronic, or other media now or in the future.  I further agree that the images and/or voice recordings and/or printed communications shall ne the property of the Released Parties.  I give permission to the Released Parties to condense, reproduce and/or publish these materials, in whole or in part as it deems.

The volunteer opportunity for which I am being considered requires me to consent to a criminal background check as a condition of employment.  This check includes the following:  criminal history reference searches for felony and misdemeanor criminal convictions for offenses against persons, civil adjudication of abuse or financial exploitation of a vulnerable adult and disciplinary board final decisions and subsequent criminal charges. If I am hired before that report is received, my employment (or volunteer opportunity) will be conditioned upon the receipt of a satisfactory report.

I hereby authorize Sound Generations to conduct the criminal background check described above.  In connection with this, I also authorize the use of law enforcement agencies to assist Sound Generations in collecting this information.  Washington State Patrol has been secured as a third party vendor to assist Sound Generations in collecting and verifying information.

I also am aware that records of arrests on pending charges and/or convictions are not an absolute bar to employment.  Such information will be used to determine whether the results of the background check reasonably bear on my trustworthiness or my ability to perform the duties of my position in a manner which is safe for Sound Generations clients and employees.

Have you ever been convicted of a criminal offense or have any pending criminal charges against you? *This refers only to felonies and misdemeanors; you do not need to include non-criminal traffic violations or municipal ordinance violations.

UNDER PENALTY OF PERJURY, I certify that to the best of my knowledge, the information provided is true and complete. I understand that any falsification or omission of information may disqualify me for this position and/or may serve as grounds for the severance of my employment with Sound Generations.  By signing below I hereby provide my authorization to Sound Generations to conduct a criminal background check and I acknowledge that I have been informed that I may request a copy of the completed background check should I wish to receive one. 

The following demographic questions are strictly confidential and optional. Responses as a whole will be used for funding and grant purposes and to further our organization’s mission. At Sound Generations we embrace the belief that racial and other social identities should be respected and affirmed.