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Citizen Action Request
General Information
Lake County BCC
315 West Main St.
P.O. Box 7800
Tavares, Florida 32778


 Volunteer Application
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LCBCC is an equal opportunity employer and a drug-free workplace. Persons needing accomodations in accordance with the Americans with Disabilities Act, please notify the LCBCC Volunteer Program at 352-343-9596. You must be at least 18 years of age to volunteer.



The following questions are required.
* Have you had any traffic violations during the last five (5) years?
If yes, please explain
* Have you had your license suspended or revoked during the last 5 years?
* Have you ever been convicted, plead guilty or no contest (Nolo Contender) to any criminal violation of law, including criminal traffic offenses? (A conviction does not automatically mean you cannot be considered. Provide all the facts.)
* Have you ever been discharged for any reason from any job?
* Have you ever been employed by Lake County Government?
* Are any members of your family or relatives (by blood or marriage) employed by Lake County Government?
* Are you able to perform the essential functions of the position with or without reasonable accommodations?


Emergency Contact Information

READ THIS SECTION CAREFULLY BEFORE SUBMITTING THE APPLICATION

My signature below attests that I am desirous of volunteering my services for the good of Lake County by assisting and rendering services to the Lake County Board of County Commissioners, located at PO Box 7800, Tavares, Florida, 32778, and,

WHEREAS, Lake County, a political subdivision of the State of Florida, hereinafter referred to as COUNTY, is desirous of receiving volunteer services from concerned citizens.

NOW THEREFORE, in the interest of performing these services, I fully understand and agree to the following described terms and conditions:

1. All of the services and assistance, which I may render, are strictly and entirely on a volunteer basis. I understand that I have the right to terminate my volunteer service at any time with or without cause, and that the County has the same right. Consequently, the COUNTY is neither responsible nor liable for the payment of any monetary remuneration to me for the performance of those services. I further understand and agree that I will not receive nor will the COUNTY provide to me any other benefits which may be available to paid employees, including, but not limited to, health or life insurance, paid vacation, sick leave, social security or retirement benefits.

2. I realize that certain areas of governmental business may involve information or documentation which is confidential or which is exempt from public disclosure. I agree, that should I ever receive or otherwise become privy to said information or documentation, that I shall maintain the same in a confidential manner and that I shall not disclose the whole or any segment thereof to any other person or entity.

3. Background checks (driving record and criminal) will be conducted for volunteer candidates.

4. Effective Date
This letter, together with its terms and conditions, shall become effective on the day of and shall continue in full force and effect until said services have ended and no future services are contemplated.


By my signature below, I hereby attest that I have read and fully understand the foregoing terms and conditions, that I am of sound mind, and that I have reached at least my eighteenth (18) birthday preceding the execution of this Letter of Understanding.

Lake County BCC Copyright 2006
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