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928 Northwest Beca Avenue
Corvallis, OR, 97330
United States


Intake Documents

Do not fill this information out unless directed to this page by The Arc Benton
administration or management staff.

Volunteer Agreement

I recognize that, as a volunteer I represent The Arc of Benton County to the public. I accept the responsibility for this status and will conduct myself in a professional manner. I will be clean and sober when conducting business as a representative of this organization. *
I will not participate in and will report any and all instances of any sort of harassment, exploitation, and or intimidation. I will work to maintainan atmosphere of physical and emotional safety for everyone associated with the organzation: (employees, volunteers, clients, and visitors). *
I agree to maintain the confidentiality of all volunteers, clients, and donors about whom I have personal and identifying information. *
I agree to provide advance notice as is possible in the event that I will be absent from my volunteer shift. I agree to update my personal information and emergency information as changes occur. *
I am aware that as a volunteer I expose myself to potential hazards which include but are not limited to: kitchen accidents, cuts, back injury from lifting, airborne pathogens, falls, etc. I am voluntarily participating in this service with the knowledge of the potential hazards involved and hereby agree to accept any and all risks of injury. *
I agree that my assignees, heirs, distributes, gaurdians, and other legal representatives will not make a claim against, or sue for injury or damage resulting from the negligence or other acts, howsoever caused, by any employee, agent, or volunteer contractor of the organization as a result of my participation as a volunteer. I hereby release The Arc of Benton County from all actions, claims, or demands that I, my assignees, heirs, gaurdians, and legal representatives now have or may hereafter have for injury resulting from my participation as a volunteer. *
I agree that all intellectual property and tangible product created as part of and during my internship, employment, or volunteer work remains the property of The Arc of Benton Coutny. *
If my volunteer service includes driving an automobile, I acknowledge that I have both valid driver's license and automobile liability insurance policy as required by state law. I agree to maintain my license and insurance in good standing for my entire tenure as a volunteer for the organziation. I am knowledgable of and agree to abide by local and state traffic laws. I agree not to drive while under the influence of alcohol and/or other intoxicating substances. *
I have carefully read this agreement and fully understand its contents. I am aware that this is a release of liability and sign it of my own free will. *
Name *
Today's date *
Today's date

Background Check Form/

Name *
Today's Date *
Today's Date
Gender *
Check only if you prefer correspondence be sent to your residential or mailing address (rather than email)
During the last (5) five years, have you been outside of Oregon for 60 days in a row or more? *
Start, end, city, state, country, name(s) used at this residence
Have you ever been charged, arrested and/or convicted of a crime? *
date (mm/dd/yyyy) of charge outcome, charge, arrest or conviction, outcome (e.g. conviction, dismissal), city, county, state
I understand that a criminal records check, which may include a national criminal records check requiring fingerprints, will be completed on me. I understand that an abuse check will be complted on me. The BCU may share information with a designee at the facility associated with this request. My submission of this electronic signature authorizes the BCU to request and receive any juvenile, police, court, or investigation reports needed to complete this background check. In the event potentially disqualifiying abuse is discovered, I will be notified at the address or email I have given and asked to provide additional information. I authorize, the BCU to process , this background check and request. I understand the background check may be repeated during the time I hold this position. *

Mandatory Abuse Reporting

I have opened the Mandatory Abuse Reporting PDF file above, read the contents, and agree to the terms and conditions.
Name *
Today's Date *
Today's Date