- Application - Vulnerable Sector Check Fee Waiver

Transcription

1 The Volunteer Screening Program (VSP) provides a Check (VSC) Fee Waiver which helps organizations alleviate costs for VSCs. To receive the Fee Waiver eligible organizations, with approved volunteer positions requiring VSCs, need a Volunteer Screening Program Number (VSPN). VSPNs for VSC Fee Waivers will be issued to organizations with eligible and approved volunteer positions only. Volunteer positions which are not approved will not be authorized for a VSC Fee Waiver. Deadline: Open Please read and review this application form thoroughly and ensure you have provided all information required. Criteria In order to access and qualify for the Check (VSC) Fee Waiver, organizations must work with vulnerable populations and engage volunteers in positions of trust or authority. Current Participating Communities: Airdrie, Calgary, Camrose, Edmonton, Lacombe, Lloydminster, Lethbridge, Medicine Hat, St. Albert, and Vegreville. For more information about eligibility criteria and position criteria, please visit our website. If you answer YES to EITHER question, your organization is NOT eligible for the fee waiver. Is your organization operationally funded by Alberta Health Services (e.g. Capital Care, Covenant Health, CareWest)? Yes Is your organization a university, college, post-secondary program or institution funded through Alberta Advanced Education? Yes If you answer YES to these questions, your organization MAY BE eligible for the Fee Waiver. Does your organization work with vulnerable populations? Yes Does your organization engage volunteers who are in a position of trust and authority toward vulnerable populations? Yes Do your volunteers have unsupervised access to vulnerable populations? Yes Does your organization operate within one of the current participating communities? Yes *The Volunteer Screening Program (VSP) is subject to funding from the Government of Alberta. Page 1 of 10

2 Organization Profile Your organization must meet the following criteria: is self-governing and exists to serve the public benefit; does not distribute profits to owners, members, directors, shareholders, or managers; is voluntary (benefits to some degree from voluntary contributions of time and money); is currently operating in the Province of Alberta and has been for at least one year; is incorporated, established, and/or registered in Alberta under the laws of Alberta or Canada, including one of the following Acts (please indicate the appropriate Act(s) below): Agricultural Societies Act Canada Corporations Act (nonprofit sector) Cemeteries Act or Cemetery Companies Act Regional Health Authorities Act (Foundations) Libraries Act Part 9 of the Companies Act (nonprofit) Part 21 of the Business Corporations Act Extra-Provincial Corporations Societies Act Special Act of the Parliament of Canada Special Act of the Alberta Legislature is currently operating in the Province of Alberta, with a sole mandate to provide programs and services to Albertans. Your organization (select all that apply): is an educational institute (notwithstanding a college, university or post-secondary institute); and is a faith-based institution that provides philanthropic services to the broader community (If YES, page 10 must be completed and submitted). ORGANIZATION INFORMATION Legal Name: Operating Name (if different from above): Nonprofit Registration Number: Subsector: Mailing Address: City/Town: Province: Postal Code: (general inbox): Fax: Website: Page 2 of 10

3 PROGRAM CONTACT: Name: Position/Title: Phone: OPERATIONS & VOLUNTEER ENGAGEMENT Mission, Vision, and Values (please describe organization mandate and/or purpose): Programs and Services (please provide a brief description): Clients, Participants, and Recipients (please describe the people served by organization): Communities Served and/or Operating Within (please describe the area and reach): Number of All Current Volunteers Involved in Operations: Number of Board Members: Page 3 of 10

4 Volunteer Positions Organizations are required to clearly define each volunteer position requiring a Check (VSC) as part of this application. If you are applying for more than five volunteer positions, please download and submit as many forms as needed. Only one form requires all criteria filled out, additional forms only need detailed volunteer position descriptions. Please note: A Volunteer Screening Program Number (VSPN) is issued to eligible organizations that provides access to the Fee Waiver for approved volunteer positions requiring VSCs. VSPNs for VSC Fee Waivers are issued to organizations for eligible and approved volunteer positions only. Volunteer positions that are not approved will not be authorized for a Fee Waiver. VOLUNTEER POSITION #1 Position Title: Number of Volunteers Required for this Position: Estimated Number of Volunteers to be Screened During Program Year (February 1, 2017 January 31, 2018): Position Responsibilities (Duties/Activities) Please provide a detailed description of the role, how the role interacts with vulnerable populations, the level of authority and trust the volunteer has with the vulnerable population, and the level of unsupervised access the volunteer has with the vulnerable population. Organizations may use the space provided above or submit position description as separate attachments. For resources or tools, please visit our webpage. Volunteer Position Eligibility (Please Select All that Apply): Volunteer works with those who are under the age of Yes Volunteer works with those who are over the age of Yes Volunteer works with those who have a disability (physical or mental, permanent or temporary) Yes Volunteer has unsupervised access to client Yes Volunteer is in a position of trust or direct authority over the client Yes Client is dependent upon the volunteer Yes Page 4 of 10

5 VOLUNTEER POSITION #2 Position Title: Number of Volunteers Required for this Position: Estimated Number of Volunteers to be Screened During Program Year (February 1, 2017 January 31, 2018): Position Responsibilities (Duties/Activities) Please provide a detailed description of the role, how the role interacts with vulnerable populations, the level of authority and trust the volunteer has with the vulnerable population, and the level of unsupervised access the volunteer has with the vulnerable population. Organizations may use the space provided above or submit position description as separate attachments. For resources or tools, please visit our webpage. Volunteer Position Eligibility (Please Select All that Apply): Volunteer works with those who are under the age of Yes Volunteer works with those who are over the age of Yes Volunteer works with those who have a disability (physical or mental, permanent or temporary) Yes Volunteer has unsupervised access to client Yes Volunteer is in a position of trust or direct authority over the client Yes Client is dependent upon the volunteer Yes Page 5 of 10

6 VOLUNTEER POSITION #3 Position Title: Number of Volunteers Required for this Position: Estimated Number of Volunteers to be Screened During Program Year (February 1, 2017 January 31, 2018): Position Responsibilities (Duties/Activities) Please provide a detailed description of the role, how the role interacts with vulnerable populations, the level of authority and trust the volunteer has with the vulnerable population, and the level of unsupervised access the volunteer has with the vulnerable population. Organizations may use the space provided above or submit position description as separate attachments. For resources or tools, please visit our webpage. Volunteer Position Eligibility (Please Select All that Apply): Volunteer works with those who are under the age of Yes Volunteer works with those who are over the age of Yes Volunteer works with those who have a disability (physical or mental, permanent or temporary) Yes Volunteer has unsupervised access to client Yes Volunteer is in a position of trust or direct authority over the client Yes Client is dependent upon the volunteer Yes Page 6 of 10

7 VOLUNTEER POSITION #4 Position Title: Number of Volunteers Required for this Position: Estimated Number of Volunteers to be Screened During Program (February 1, 2017 January 31, 2018): Position Responsibilities (Duties/Activities) Please provide a detailed description of the role, how the role interacts with vulnerable populations, the level of authority and trust the volunteer has with the vulnerable population, and the level of unsupervised access the volunteer has with the vulnerable population. Organizations may use the space provided above or submit position description as separate attachments. For resources or tools, please visit our webpage. Volunteer Position Eligibility Volunteer Position Eligibility (Please Select All that Apply): Volunteer works with those who are under the age of Yes Volunteer works with those who are over the age of Yes Volunteer works with those who have a disability (physical or mental, permanent or temporary) Yes Volunteer has unsupervised access to client Yes Volunteer is in a position of trust or direct authority over the client Yes Client is dependent upon the volunteer Yes Page 7 of 10

8 VOLUNTEER POSITION #5 Position Title: Number of Volunteers Required for this Position: Estimated Number of Volunteers to be Screened During Program Year (February 1, 2017 January 31, 2018): Position Responsibilities (Duties/Activities) Please provide a detailed description of the role, how the role interacts with vulnerable populations, the level of authority and trust the volunteer has with the vulnerable population, and the level of unsupervised access the volunteer has with the vulnerable population. Organizations may use the space provided above or submit position description as separate attachments. For resources or tools, please visit our webpage. Volunteer Position Eligibility (Please Select All that Apply): Volunteer works with those who are under the age of Yes Volunteer works with those who are over the age of Yes Volunteer works with those who have a disability (physical or mental, permanent or temporary) Yes Volunteer has unsupervised access to client Yes Volunteer is in a position of trust or direct authority over the client Yes Client is dependent upon the volunteer Yes Page 8 of 10

9 Authorizations Authorized Signature(s): Name(s): Position(s): Date: Submission Instructions Please ensure the following is included with your application: Volunteer position descriptions (if separate attachments) Copy of current organization volunteer screening policies Copy of current volunteer screening procedures Description of Philanthropic Services (faith-based institutions, see page 10) Please return completed applications in one of the following methods: Fax: Mail or in person: Attn: Volunteer Screening Volunteer Alberta Suite 609, Jasper Avenue Edmonton AB T5J 1V9 Page 9 of 10

10 *Only to be completed by faith-based institutions. - Application - Faith-Based Institutions Description of Philanthropic Services In order to apply for the Check (VSC) Fee Waiver, faith-based organizations must provide philanthropic community programs/services to the broader community. Description of Philanthropic Services: Authorized Signature(s): Name(s): Position(s): Page 10 of 10