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SEE International Volunteer Application
First and Last Name
(Required)
First
Last
Email
(Required)
Phone
(Required)
Volunteer Day Availability
(Required)
Mondays
Tuesdays
Wednesdays
Thursdays
Fridays
Saturdays
Sundays
Volunteer Time Availability
(Required)
Mornings
Afternoons
Evenings
Education and Skills
Relevant Degrees / Certificates
(Required)
Skills: Please list any background experience that may enhance your contribution (Microsoft Office, Translation, Salesforce)
(Required)
Do You Have Any Past Participation in Volunteer Eye Programs
(Required)
Yes
No
Languages Spoken
(Required)
Are You Able to Lift 30 Pounds?
(Required)
Yes
No
In Which Department Would You Like to Volunteer
(Required)
Communications / Marketing
Development / Fundraising
International Programs
Office Admin
Warehouse
Historical Archiving
See Vision Care
By Which Method Are You Able to Volunteer?
(Required)
In person
Hybrid
Remotely
Are You a Member of Any Clubs and Associations? (Lions, Rotary, Etc.)
(Required)
How Did You Hear About SEE International?
(Required)
How Do You Hope to Contribute to SEE's Volunteer Eyecare Programs?
(Required)
What Sized T-Shirt Are You?
(Required)
XS
S
M
L
XL
XXL
Emergency Contact Information
(Required)
First
Last
Emergency Contact Phone
(Required)
Privacy Policy and Release Form
Privacy Policy
(Required)
PRIVACY POLICY: SEE International respects an individual's right to keep personal information private and does not sell or distribute data collected by this form. See our
privacy policy
for additional details.
I understand SEE's Privacy Policy
(Required)
Volunteer Waiver
This Release and Waiver of Liability executed on
(Required)
MM slash DD slash YYYY
Today's Date
by
(Required)
First and Last Name ("Volunteer")
Name of Parent/Guardian if Volunteer is Under 18
This release is between SEE International ("SEE"), a nonprofit corporation organized and existing under the laws of the State of California, and Volunteer (or a parent or legal guardian if Volunteer is under the age of 18).
The Volunteer desires to provide volunteer services for SEE and engage in activities related to serving as a volunteer.
Volunteer (or parent/guardian) understands that the scope of relationship with SEE is limited to a volunteer position and that no compensation is expected in return for services provided by Volunteer; that SEE will not provide any benefits traditionally associated with employment to Volunteer; and that Volunteer is responsible for his/her own insurance coverage in the event of personal injury or illness as a result of Volunteer's services to SEE. Further, Volunteer (or parent/guardian) releases and indemnifies SEE and its agents from any liability or claims related to Volunteer's services to SEE.
1. Release and Indemnification:
Volunteer (or parent/guardian) releases and forever holds harmless SEE, its successors and each of its directors, officers, employees, and agents from any liability, claims, and causes of action which arise from services provided to SEE. Volunteer (or parent/guardian) understands and acknowledges that this release indemnifies SEE from any liability or claim against SEE with respect to bodily injury, personal injury, illness, death, or property damage that may result from the services provided to SEE or in connection to providing volunteer services.
2. Medical Treatment:
In the event of an emergency, Volunteer (or parent/guardian) authorizes and consents to necessary medical care. Volunteer (or parent/guardian) releases and forever discharges SEE or its agents from any claim whatsoever which may arise on account of any first aid treatment or other medical services rendered in connection with an emergency during tenure as a volunteer with SEE.
3. Media Release:
Volunteer (or parent/guardian) grants to SEE all rights and interests in any photographs, images, video, audio recordings, or similar, of Volunteer made in connection with providing volunteer services to SEE. These rights are granted without compensation to Volunteer.
4. Severability:
If any provision of this Waiver is deemed prohibited or invalid by a court decision, statute, rule or otherwise, the remainder of this Waiver shall not be affected or deemed invalid.
By typing full name below, Volunteer (or parent/guardian) expresses understanding and intent to enter into this Release and Waiver of Liability willingly and voluntarily and agrees it will be interpreted and enforced in accordance with the laws of the State of California.
Digital Signature
(Required)
Volunteer Confidentiality Agreement
THIS CONFIDENTIALITY AGREEMENT (the “Agreement”) is made and entered into as of ________________________, ________ between SEE Vision Care (“SVC”) and (“Recipient”).
MM slash DD slash YYYY
1. PURPOSE
Recipient wishes to provide volunteer administrative or medical services (the “Services”) to SVC and in connection with the Services, SVC may disclose to Recipient certain confidential technical, business and patient information which SVC desires Recipient to treat as confidential.
2. CONFIDENTIAL INFORMATION
“Confidential Information” means any information disclosed to Recipient by SVC, either directly or indirectly in writing, orally or by inspection of tangible objects, including without limitation documents, patient files, oral patient histories, patient medical records, personal information and all information relating to a patient’s care, treatment or condition. Confidential Information may also include information disclosed to SVC by third parties.
3. NON-USE AND NON-DISCLOSURE
Recipient agrees not to use any Confidential Information for any purpose except to engage in and discuss the Services with SVC. Recipient agrees not to disclose any Confidential Information to any third parties. Recipient shall not disclose Confidential Information to employees of Recipient, except to those employees who are required to have the information in order to evaluate or engage in discussions concerning the Services contemplated herein.
4. MAINTENANCE OF CONFIDENTIALITY
Recipient agrees that it shall take all reasonable measures to protect the secrecy of and avoid disclosure and unauthorized use of the Confidential Information. Without limiting the foregoing, Recipient shall take at least those measures that Recipient takes to protect its own most highly confidential information. Recipient shall not make any copies of Confidential Information unless the same are previously approved in writing by SVC. Recipient shall immediately notify SVC in the event of any unauthorized use or disclosure of the Confidential Information.
5. RETURN OF MATERIALS
All documents and other tangible objects containing or representing Confidential Information and all copies thereof which are in the possession of Recipient shall be and remain the property of SVC and shall be promptly returned to SVC upon SVC's request.
6. CLINIC PRIVACY POLICY
I have read and understand the SEE Vision Care Privacy Policy attached hereto as Exhibit A. I agree to abide by such policy and understand that failure to do so will result in my immediate termination as a volunteer from SVC.
7. TERM
This Agreement shall survive until such time as all Confidential Information disclosed hereunder becomes publicly known and made generally available through no action or inaction of Recipient. This agreement shall survive Recipient’s resignation or termination from SVC.
8. REMEDIES
Recipient agrees that any violation or threatened violation of this Agreement will cause irreparable injury to SVC, entitling SVC to obtain injunctive relief in addition to all legal remedies.
9. MISCELLANEOUS
This Agreement shall bind and inure to the benefit of the parties hereto and their successors and assigns, except that Recipient may not assign or transfer this Agreement, by operation of law or otherwise, without WFC’s prior written consent. THIS AGREEMENT SHALL BE GOVERNED BY THE LAWS OF THE STATE OF CALIFORNIA, WITHOUT REFERENCE TO CONFLICT OF LAWS PRINCIPLES. This document contains the entire agreement between the parties with respect to the subject matter hereof. If any provision of this Agreement is found to be illegal or unenforceable, the other provisions shall remain effective and enforceable to the greatest extent permitted by law. Any failure to enforce any provision of this Agreement shall not constitute a waiver thereof or of any other provision hereof. This Agreement may not be amended, nor any obligation waived, except by a writing signed by both parties hereto. The parties may execute this Agreement in counterparts, each of which is deemed an original, but all of which together constitute one and the same agreement.
ACCEPTED AND AGREED TO:
MM slash DD slash YYYY
By
(Required)
Full Name
Δ
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What We Do
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Why Sight?
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Our Programs
Toggle child menu
Expand
SEE Vision Care
Medical Clinics
Countries Served
Connecting People to our Cause
Conditions We Treat
Toggle child menu
Expand
Cataracts
Refractive Errors
Glaucoma
Diabetic Retinopathy
Childhood Blindness
Corneal Blindness
Strabismus
How To Help
Education
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VISION 2020 LINKS – USA
Global Medical Libraries Partnership
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