Volunteer

Thank you for your interest in volunteering with the YWCA Lincoln Take a Break Program. Volunteers will need to have a desire to enrich the lives of young children, especially children with special needs.

Volunteers will need to pass a background check. There are two forms to complete.

The first is a Request for Information PDF and will need to be printed and emailed to tab@ywcalincoln.org or mailed to YWCA Lincoln, 1701 S. 17th Street, Lincoln, NE 68502.

Please also complete the entire fillable form below and we will get back with you as soon as possible.

Request for Information

Volunteer Application

First Name (Required)

Last Name (Required)

Birthdate

Month

Day

Year

Organization

Address (Line 1) (Required)

Address (Line 2)

City (Required)

State

Zip Code (Required)

Phone (Required)

E-mail Address (Required)

Preferred Response

Past Volunteer Experience

Why did you choose this program? (Required)

Work Experience

Current Status

Civic, Club, or Professional Affiliation

Do you have any special skills or talents that can help our program?

Other Languages Spoken

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Have you ever been convicted of a crime?

If yes, please explain

Please list THREE Educational or Professional References (teacher, coach, advisor, supervisor, pastor) (Required)

We request your cooperation in completing the following voluntary applicant demographic information. This information will not effect your eligibility to volunteer at the YWCA Lincoln. This information is gathered for grant and reporting requirements.

Gender:

Ethnic Background

White (Not of Hispanic Origin)
Black (Not of Hispanic Origin)
Hispanic (All persons of Mexican, Puerto Rican, Cuban, Central South American, or other Spanish culture or origin, regardless of race)
American Indian or Alaskan Native (All persons having origins in any of the people of North America, and who maintain cultural identification through tribal affiliation or community recognition
Asian or Pacific Islanders All persons having origins in any of the original peoples of the Far East, Southeast Asia, the Indian Subcontinent or Pacific Islands. For example, China, Japan, Korea, the Philippines Islands, and Samoa

Certification of Applicant (Required)

By submitting this form, you certify that the information contained in this application is true to the best of your knowledge and belief. You understand that any material omission of facts or misrepresentation may result in your discharge regardless of when discovered.  You grant permission to YWCA Lincoln to investigate your employment record, educational record, criminal record and other records to verify the information you have provided on this application and release YWCA Lincoln, Board of Directors, employees, and volunteers or any other person or organization that may provide such information from any liability resulting from such investigation.  I understand that my position is conditional upon the YWCA Lincoln receiving no inappropriate information on my background. I hereby release and agree to hold harmless from liability the YWCA Lincoln, Board of Directors, employees, and volunteers thereof, or any other person or organization that may provide such information. I also understand that, regardless of previous volunteering, the YWCA Lincoln is not obligated to place me in a volunteer position. If accepted as a volunteer I understand that I will be expected to follow the YWCA Lincoln policies and/or principles and if not, that I will be subject to suspension or termination.

TYPE YOUR NAME TO CERTIFY (Required)

Volunteer Application

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