Richmond, VA

Neighbor To Neighbor Volunteer Application

Logging of Volunteer Hours

City Employees
In order to log your volunteer hours, you will need to go to Starnet and click on the “Log your volunteer hours" under the N2N logo

In order to log your volunteer hours, you will need to login using your e-mail address and a password that is generated by the system. The password will be contained in your registration confirmation e-mail.

Registration Form

General Information

*First Name:

Middle Initial:

*Last Name:

Suffix:

**Address 1:

*Home Phone:

(xxx-xxx-xxxx)

Address 2:

Mobile Phone:

(xxx-xxx-xxxx)

*Zip:

City:

State:

*Email Address:

**DOB:

Month:	Day:	Year:

Employer

Education Completed:

City of Richmond Employee:

YesNo

*Best Time to Contact:

Currently Employed:

YesNo

Employer Name:

* Please note that the request for mobile and home phone numbers, as well as home E-mails, is being made so that, in the case of emergencies during non-work hours, potential volunteers can be contacted.

** Fields marked with double asterisk(**) are optional for city-employees

Emergency Contact

References

*Full Name:

Reference Name:

Address:

Contact Number:

(xxx-xxx-xxxx)

City:

State:

Zip:

Is this required for Coursework

*Home Phone:

(xxx-xxx-xxxx)

For Required Course:

YesNo

Mobile Phone:

(xxx-xxx-xxxx)

Relationship:

Volunteer Categories

Administrative ServicesBeautification and cleanupBon Secours Washington Football Team Training Camp
Emergency relief effortsEnvironment/SustainabilityGardening and Food Assistance
Health and FitnessHome RepairsHomelessness
Interpreting and Translation ServicesLawn Care for Vulnerable ResidentsLeaf RakingBagging for Vulnerable Residents
LibrariesMastergardeningOther (Please use additional comments)
PARKS and RECREATION - ArtsPARKS and RECREATION - CarpentryPARKS and RECREATION - Cleanups
PARKS and RECREATION - Cultural ArtsPARKS and RECREATION - MaintenanceRepairPARKS and RECREATION - Recreation
PARKS and RECREATION - Youth AthleticsSnow Removal for Vulnerable ResidentsSupporting families
Tutoring and mentoring children & youthWashington Football Team - AmbassadorsWork in schools (private or public)
Work with elderly and/or the disabledWork with VeteransYouth on Parole or Pending Adjudication

List any additional information not listed (i.e. certifications):

Number of Characters Remaining: 500

Availability

	Sun	Mon	Tue	Wed	Thu	Fri	Sat
AM
PM

Certification, Authorization and Release

I certify that I am at least 18 years old or older.I certify that I am under 18 years old.

I agree that the City of Richmond may use my likeness in any brochures or promotional materials that will be used to promote the City of Richmond.

YesNo

Have you had a background check through the city within the last year?

YesNo

I certify that the information I have given is true and complete and that no attempt has been made to conceal pertinent information. I understand that any false or misleading information may be cause for the dismissal at any time and agree to hold the City of Richmond, its agents, employees, and volunteers harmless in that event.

I authorize to the City of Richmond, and its agents, to conduct all necessary background checks in connection with my application. This investigation may include information as to my criminal background, motor vehicle records, sex offender registry checks, addresses, employment history, high school attendance, professional references, and other appropriate sources. Any person, firm, or organization providing information or records in accordance with this authorization is released from any and all claims of liability for compliance. Such information will be held in confidence in according to the city policy.

I assume full responsibility for such participation and release the City of Richmond from any damages which I may sustain thereby. I fully understand that if my services are no longer needed, or my performance is not acceptable, the city has the right to terminate my services as required and without notice.

I certify that by submitting this form I comply with all the terms under the "Certification, Authorization and Release" section of this form.

Internal Use Only Internal Use Only

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