CI Panel Volunteer Registration

Registration for 2022 CI Panels

OPEN OCTOBER, 2021 THROUGH DECEMBER 15 TH 2021.

Required field(s) are indicated by an *.
(if preferred)
(if applicable)


If no, please fill the below address information.





(Wheelchair, etc.)



If you are registering as a new CI Panel Volunteer, how did you learn of this opportunity?





Please provide the following demographic data for use in creating balanced panel representation:



Ethnicity
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Potential Conflicts of Interest

List any potential conflicts of interests including any local health and human service organizations with which you or a member of your immediate family currently and/or within the past 5 years serves (or served) as a volunteer, board member or staff member; any member agencies that you were employed by in the past and the dates you were employed by them; any member agencies that you or your employer interact with professionally (i.e. perform annual audit for an agency, collaborate to provide service, compete for funding from the same sources, etc.)

By clicking the check box below indicates agreement with the following statements:

  • I wish to participate as a Community Investments Volunteer. I understand that as a Community Investments Volunteer, I am committing to devote the time necessary to fulfill my Community Investment role including meetings held during regular business hours.
     
  • I have obtained permission from my employer for time required away from work for me to participate as a Community Investments Volunteer.
     
  • I have read and accept the TULSA AREA UNITED WAY CODE OF ETHICS.
     
  • I have read and understand the options in the TULSA AREA UNITED WAY COMPLAINT AND WHISTLEBLOWER POLICY .
     
  • I have reviewed the list of TAUW PARTNER AGENCIES, and I have disclosed all potential conflicts of interest I may have with Partner Agencies.
     
  • I understand that all of the information Partner Agencies submit to Community Investments Volunteers and all of the materials and discussion generated by the Community Investments Volunteers is confidential, and I agree not to share it with others outside of TAUW Community Investments.
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Geographical Area(s) of Interest
  Site visit may require travel to the following areas: