Please fill in our online form below or download our application here.
We receive United Way funds & are required to collect certain statistics, which are reported by category; volunteers' names are never provided.
Employers &/or volunteer supervisors, clergy, teachers, colleagues, co-workers are preferred; friends
or relatives are not accepted. We suggest getting the references' permission to use their name. At least one
reference must be local. List name, phone number (required) & relationship to you.
Your Volunteer Preferences (check any that apply):
I certify that the statements made by me are true and correct, to the best of my knowledge. I will not withhold
information that might affect my application for a volunteer position, and I understand that misrepresentations or
omissions may be cause for my immediate rejection as an applicant for a volunteer position with Jewish Social Services,
or my termination as a volunteer. I grant permission to Jewish Social Services to verify documents I submit and
statements I make. I agree to release and hold harmless from liability any person or organization that provides
information, as well as Jewish Social Services. I understand that this is an application and not a commitment or promise
to provide me a volunteer placement with JSS. My signature below applies to all of the following:
Volunteer Confidentiality -
I have discussed and understand the need to protect the privacy of Jewish Social Services of Madison (JSS) and its service
recipients, and agree to respect the confidentiality of all client information that I observe and am privy to as a volunteer of
JSS. All information regarding individuals is to be kept within the confines of JSS, its programs and/or facilities. Client
information is to be discussed only with JSS social service staff.
Additionally, confidential health information is to include all information past, present or future that may reveal
something about the individuals' physical and/or mental health.
In the event of an emergency I should call 911.
If I observe anything regarding a JSS client that concerns me, this confidentiality agreement requires that I report it as
soon as possible to the social service staff at 608-278-1808, during office hours (Monday-Friday, 9:00-5:00).
Confidentiality extends to all public relations material. Volunteers may not discuss JSS clients with any form of media,
without prior approval of JSS. The information in Jewish Social Services volunteer records is to be discussed only with
JSS social service staff.
Photographic Release - I give permission for personal information, quotes and photographs of me to be used as part of Jewish Social Services' promotional materials, and news coverage.
Criminal Background Check - I understand and accept that policy that criminal background checks are part of this volunteer application, and that this
information will be kept confidential. I also understand that I may be denied the opportunity to volunteer or be terminated
as a volunteer based on the results of the background check.