Reference Contact

Reference Name *

Reference Phone *

Reference Email

Available On Short Notice *

Yes

How Often Would You Like to Participate as a Volunteer?

Availability

	SUN	MON	TUE	WED	THU	FRI	SAT
Morning
Afternoon
Evening

Do you speak English fluently?

Yes

Languages

Please describe any other education, special skills and/or experience that may be relevant to DCASE

Education

Employer Name

Street 1

Street 2

City

State

Zip Code

Work Phone

Referred From

Accessibility

DCASE welcomes people with disabilities. Do you need any type of reasonable accommodation to serve as a DCASE volunteer?

Yes

If yes, please describe

LIABILITY WAIVER AND AGREEMENT

Liability: "The undersigned hereby understands and agrees to personally assume any and all liability and risk of volunteering at the Department of Cultural Affairs and Special Events. Further, the undersigned hereby agrees to hold harmless the City of Chicago, its employees, and agents from any responsibility or liability for any and all personal injuries that may occur while volunteering at the office or during off-site events."

The undersigned understands and agrees that if accepted as a volunteer, he/she would not be an employee of the City of Chicago, and would not be entitled to any compensation or benefits of any kind.

Agreement: By submitting this application, I affirm that the facts set forth in it are true and complete. I understand that if I am accepted as a volunteer, any false statements, omissions, or other misrepresentations made by me on this application may result in my immediate dismissal.

I Agree

Thank You!

Your application has been submitted. You should be receiving a confirmation email soon from us with information about the next steps in the process. Thank you for your interest in DCASE.