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Volunteer Paid Time Off Program Application
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To submit a request to utilize your Volunteer Paid Time Off, please complete the application form below.
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I am requesting consideration for participation in the American Marketing & Publishing Volunteer Paid Time Off Program. I've familiarized myself with AMP's objectives in offering this program and understand that in offering it, one of AMP’s objective is to foster a sense of community, connectedness, and a deeper appreciation for our own life circumstances. I acknowledge that my proposed volunteer activity, described in more detail below, meets the eligibility guidelines for AMP VPTO. I understand that this application may be approved or denied by my direct supervisor or by Human Resources, and that if approved, AMP's pay for the hours of VPTO is contingent on my timely submission of a Post Volunteering Report.
Your Email
*
Date of Proposed VPTO
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# of Hours Requested
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Choice 1
4
8
I am eligible to participate in the Program as I have tenure of at least 120 days of active work
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Choice 1
Yes
No
I am not currently on a Performance Improvement Plan or similar program to bring my workplace performance up to a more acceptable level:
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Choice 1
Yes
No
Name of Nonprofit, Governmental Entity, or School, Location, and Telephone #
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Please Briefly Describe Your Intended Volunteer Activity
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My direct supervisor is:
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Is the volunteering scheduled during standard business hours?
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Choice 1
Yes
No
Will you be compensated (other than through VPTO) in any way?
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Choice 1
Yes
No
Does the activity directly benefit you or a family member?in any way? (copy)
*
Choice 1
Yes
No
In consideration of my application and permitting me to participate in this event, on behalf of myself, my executors, administrators, heirs, next of kin, successors, and assigns, I: (A) waive, release, and discharge from any and all liability for my death, disability or personal injury which may accrue in connection with my participation in this volunteer event, AMP and its directors, officers, employees, volunteers, representatives and agents, and (B) indemnify and hold harmless all entities or persons mentioned in this paragraph from any and all liabilities or claims made by other individuals or entities as a result of my actions during this event.
Name
*
First
Last
Submit and agree to the Volunteer PTO Policy Guidelines