CT HOBY 2018 Volunteer Application Header Image

Volunteer Registration

Dear Potential Volunteer,


Thank you for offering to volunteer your time for HOBY!


Our primary event, the Connecticut HOBY Leadership Seminar, will take place Friday, June 1 through Sunday, June 3, 2018. The event will be held at the University of Bridgeport, with more than 150 sophomores in attendance. During the weekend, you will join “HOBY Ambassadors” from our state, as well as many other volunteers, to enjoy a unique leadership experience. We will present multiple viewpoints on important issues and encourage students to think critically about leadership, and also begin to identify their own particular leadership strengths. The seminar will be an enjoyable experience in a stimulating workshop environment. We tell Ambassadors that what they get out of the seminar will correlate directly with their level of participation in the activities, and you as a volunteer will help them interact to get the most of this experience.


Herein included, please find several HOBY forms that require your attention, as well as some information you may like to have regarding the seminar. Please ensure that you thoroughly review and complete all of the forms ASAP. All applications are due by January 15th, 2018. This deadline is for both this site application and your annual HOBY International Online Application.


If you have any questions, please contact Director of Facilitators, Kitty Moon Dorsey, Alumni Team Director, Courtney McHale, or Mike Roy, Leadership Seminar Chair at the email addresses below. We are delighted to have you as part of this HOBY event and are grateful for the time and leadership you have volunteered!


Sincerely,


Mike Roy

Leadership Seminar Chair

mroy@cthoby.org


Kitty Moon Dorsey

Director of Facilitators

facilitator@cthoby.org


Courtney McHale

Alumni Team Director

jstaff@cthoby.org

Acknowledgement

Please be advised that this volunteer application is extensive and will take you some time to complete. It contains an Annual Background Check Form, acknowledgement of the HOBY International Online Volunteer Application (which must be completed seperately), volunteer confirmation, medical history, consent & acknowledgement of risk, HOBY Code of Conduct, as well as additional information to help us best find a place for you on our volunteer team. Collection of this data is done for all volunteer applicants so that it is already on file once you begin to volunteer with us. All data is maintained securely and is protected by HIPAA law.


This application must be completed on an annual basis.


If you are under 18, this form set has multiple places that will require a parent or guardian electronic signature. You will want them present as you complete the forms.


You may save and resume completion of this form by using the link at the bottom of any page. However, without the link provided, the data you have entered cannot be retrieved and you will have to start filling out the form at the beginning. Because of the security measures in place with this form including 256 bit SSL and the highest level of data encryption available, which ensures that only verified HOBY volunteers on a need to know basis can access any submitted information, should you use "Save and Resume," providing your own self-created password will be necessary. Additionally, as part of these security measures, neither HOBY nor Formstack will be able to retrieve your personal "Save and Resume" link or password. You will be able to email yourself the link when it is provided.
  • Social Security Number (for those 18 or older)*
  • Place of Birth*
  • Medical History+
  • Immunization Record+
  • Medical Insurance (if applicable)+
  • Headshot of yourself (to digitally upload)

Starred (*) items are used in our background check conducted by One Source. Items with a plus (+) are collected for emergency purposes and treated as Personal Health Information (PHI) and protected by HIPAA law.

We value and respect your personal safety and security including that of your information and treat it with the highest regard.


Any questions, concerns, or technical errors with this form may be reported to mroy@cthoby.org.

I am 18 years of age or over.*
Please answer this question as your age on the day of the seminar mentioned above. You do NOT need to be 18 years of age to complete this application. This question simply allows us to determine the appropriate information to further ask of you.

Basic Personal Information

Full Name*
Home Address*

Gender*

HOBY Annual Background Check Form for Volunteers

Applicant Release Authorization


In accordance with the Child Protection Policy of Hugh O’Brian Youth Leadership (HOBY), all volunteers 18 years and older who will have repetitive access or contact with Ambassadors, or who will sit on the local affiliate corporate board must complete this form and agree to an background check annually. Background checks for individuals accepted to the positions of Regional Project Director (RPD) and Corporation President (CP) will be conducted by HOBY International; background checks on all other volunteers will be conducted by the Corporation President of the local affiliate HOBY corporate board.

The information provided on this form is required by law enforcement agencies and other entities for positive identification purposes when checking public records. It is confidential and will not be used for any other purposes. I hereby release the employer and agents and all persons, agencies, and entities providing information or reports about me from any and all liability arising out of the request for or release of any of the above and/or below mentioned information or reports.

I hereby authorize, without reservation, any law enforcement agency, institution, information service bureau, school, employer, reference or insurance company contacted by Hugh O’Brian Youth Leadership (HOBY) or its background check service provider or agent, to furnish the information described above and/or below. I understand that in the event a negative hiring decision is made based upon the results of my background check, a report will be furnished to me upon my request. I understand that, regardless of previous appointments, HOBY is not obligated to appoint me to a volunteer position. If appointed, I understand that violation of HOBY policies or principles could be subject to my suspension or removal by HOBY staff.

Date of Birth*
Format with hyphens
Country
State
City
If you're a student without a job, write "none."
If you're a student without a job, write "student."
Have you ever been convicted of a crime?*

I CERTIFY THAT THE INFORMATION ON THIS APPLICATION IS TRUE.

Use your mouse or finger to draw your signature above
Print Your Name*
Date*

HOBY International Online Volunteer Application

HOBY International requires all HOBY volunteers to apply through their website. You can complete the application at:

https://reg.hoby.org/HOBYVolunteerApplication/

Please Note:

If this is your first year volunteering, you do not need a username and password to enter the application. Simply click the "Continue" button under "New Volunteers". Returning volunteers should log-in using the username and password they were issued when they last volunteered. If you do not remember this or have it in an old email, contact Kevin Grace, Director of National Programs, at gracek@hoby.org to retrieve it for you.

Please indicate the position you are applying to hold at the CT HOBY 2018 seminar.
YOUR State Site (if none, leave blank)
If you don't have an alumni year, write "none."
Do not include your alumni year (if applicable).
Online Application Status*

Education and HOBY Experience

I am 21 years of age or older.*
OR will be age 21 by May 25, 2018.
IF YOU ARE NOT IN HIGH SCHOOL, LEAVE THIS BLANK!
If none, write "none."
CT HOBY is looking for veteran Facilitators and Junior Facilitators to help with components of E-Trainings and On-Site Seminar Trainigs. Please mark if you would be willing to assist with leading any of the following in the Facilitation staff training:
Keep is simple and honest! :)

Junior Staff

Questions IN THIS SECTION ONLY are for CT HOBY Junior Staff Applicants (under the age of 21).

Parent/Guardian Name*
I am a:*
Jacket Size*
I was on Junior Staff last year.*
I would like to have my same job and responsibility as last year*
Selection here does NOT indicate a final choice; we are simply gauging interest.
https://reg.hoby.org/HOBYL4S/

Getting To Know You...

All CT HOBY Staff Applicants must fill the top section out.

Keep it simple! :)
Keep it short, please. :)
Om nom nom!
I am a:
When I find myself in a new social situation _____.

Personality Test

Each question has 4 sets of words that are to be ranked. 4 is the MOST like you, and 1 is the LEAST like you. Rank from 1 to 4 as you see yourself. You may only use each value ONCE per question.

Question 1*
Question 1
  1 - Not Really Like Me 2 - Somewhat Like Me 3 - Mostly Like Me 4 - Extremely Like Me
Active, Variety, Sports, Opportunities, Spontaneous, Flexible
Organized, Planned, Neat, Parental, Traditional Responsible
Warm, Helpful, Friends, Authentic, Harmonious, Compassionate
Learning, Science, Quiet, Versatile, Inventive, Competent
Each question has 4 sets of words that are to be ranked. 4 is the MOST like you, and 1 is the LEAST like you. Rank from 1 to 4 as you see yourself.


Question 2*
Question 2
  1 - Not Really Like Me 2 - Somewhat Like Me 3 - Mostly Like Me 4 - Extremely Like Me
Curious, Ideas, Questions, Conceptual, Knowledge, Problem Solver
Caring, People, Oriented, Feelings, Unique, Empathetic, Communicative
Orderly, On-time, Honest, Stable, Sensible, Dependable
Fun, Action, Challenges, Competitive, Impetuous, Impactful
Each question has 4 sets of words that are to be ranked. 4 is the MOST like you, and 1 is the LEAST like you. Rank from 1 to 4 as you see yourself.


Question 3*
Question 3
  1 - Not Really Like Me 2 - Somewhat Like Me 3 - Mostly Like Me 4 - Extremely Like Me
Helpful, Trustworthy, Dependable, Loyal, Conservative, Organized
Independent, Exploring, Competent, Theoretical, Why?, Ingenious
Playful, Quick, Adventurous, Confrontational, Open Minded, Independent
Kind, Understanding, Giving, Devoted, Warm, Poetic
Each question has 4 sets of words that are to be ranked. 4 is the MOST like you, and 1 is the LEAST like you. Rank from 1 to 4 as you see yourself.


Question 4*
Question 4
  1 - Not Really Like Me 2 - Somewhat Like Me 3 - Mostly Like Me 4 - Extremely Like Me
Sharing, Getting Along, Feelings, Tender, Inspirational, Dramatic
Active, Free, Winning, Daring, Impulsive, Risk Taker
Thinking, Solving Problems, Perfectionist, Determined, Complex, Composed
Follow Rules, Useful, Save Money, Concerned, Procedural, Cooperative
Each question has 4 sets of words that are to be ranked. 4 is the MOST like you, and 1 is the LEAST like you. Rank from 1 to 4 as you see yourself.


Question 5*
Question 5
  1 - Not Really Like Me 2 - Somewhat Like Me 3 - Mostly Like Me 4 - Extremely Like Me
Puzzles, Seeking Information, Making Sense, Philosophical, Principles, Rational
Social Causes, Easy Going, Happy Endings, Approachable, Affectionate, Sympathetic
Exciting, Lively, Hands On, Courageous, Skillful, On Stage
Pride, Traditional, Do Things Right, Orderly, Conventional, Careful
Each question has 4 sets of words that are to be ranked. 4 is the MOST like you, and 1 is the LEAST like you. Rank from 1 to 4 as you see yourself.

Seminar-Specific Volunteer Form

T-shirt Size*
Please upload a headshot of yourself*
No File Chosen
File uploads may not work on some mobile devices.
JPG, JPEG, and PNG formats acceptable
Housing Choice*

Please select the teams* you are interested in applying for:

*(if applicable)

Please feel free to reach out to Kitty or Mike with any questions about these teams!

Include relevant information about any special talents, skills or abilities that you have which may make you a good fit for the particular roles you are interested in.

Skills/Technology

If you are applying to be a facilitator, feel free to skip this. Otherwise, feel free to fill this information in if we can contact you to help us out in these fields.

Check any/all skills that you feel confident with
Do you own a computer that you CAN and WILL bring to seminar?*
Do you own a tablet that you CAN and WILL bring to seminar with you?*
Do you have a digital camera you CAN and WILL bring to seminar?*
Do you have your own cell phone?*
Do you have limitations on your minutes/data?*

Travel Information

Volunteer will arrive at the HOBY Leadership Seminar by:*
If unsure at the time of filling out the application, please email your director as soon as you know what your plans are.
Are departure plans different?
Volunteer will depart the HOBY Leadership Seminar by:*
If unsure at the time of filling out the application, please email your director as soon as you know what your plans are.
...or let us know if there may be complications.

Being Driven/Driving:


Note: Volunteers under the age of 18 that drive themselves to the seminar are required to surrender their car keys upon arrival; they will be returned at the conclusion of the seminar.


Team Alumni members are NOT permitted to drive themselves to seminar.


Parents: HOBY strongly discourages students from driving themselves to and from the seminar; students are typically very tired by the end of the weekend.

Driver
If this person is your Emergency Contact, you can write "see emergency contact."
NAME and (###)-###-####

Flying:

I am still looking for flights, and I will email the Director of Facilitators when I have obtained my flight information.
Arrival:
:  
Departure:
:  

Bus/Train Info:

Arrival:
:  
Departure:
:  
By initialing here, I understand and acknowledge that all transportation to and from the seminar facility is my responsibility. This includes responsibiility during any connection flights, bus transfers, or in between modes of transportation.
By initialing here, I understand and acknowledge that all transportation to and from the seminar facility is my responsibility. This includes responsibiility during any connection flights, bus transfers, or in between modes of transportation.

Leadership Lunch

Annually as part of our programming, CT HOBY conducts a "leadership lunch" in which guests are invited to sit with approximately eight of our student ambassador participants. We ask each guest to make a donation in part to cover that meal for themselves and whom they sit with. We would like your help in finding individuals who might be a good fit to participate in this event. Your recommendations of individuals will help us fill out the 36 tables of individuals we are looking for, and make our event complete.

Suggested Lunch Guest 1

Medical History Record

Emergency Contact Information

Emergency Contact*
Please check the following diseases the volunteer has had in the past:*
Check the following conditions the volunteer has had or are subject to now:*
Are any treatments or medications required for any of the above conditions for the volunteer?*
If none, write "none."
Has the volunteer ever been hospitalized or had serious illnesses?*
If none, write "none."
Are there are any limitations on the amount of physical exercise the volunteer can engage in?*
If none, write "none."
Does the volunteer have any non-food and non-medicine allergies (insect stings, plants, etc.)?*
If none, write "none."
Please check all that apply with respect to dietary restrictions:*
Does the volunteer have any allergic reactions to medication (penicillin, sulfa drugs, tetnus antioxin, etc.)?*
If none, write "none."
If none, write "none."
Is the volunteer taking any prescription medications?*
Please mark the below over-the-counter medications that you approve to be administered by HOBY:*
Is a specific decongestant necessary?*
Please list the type of illness the participant has received immunizations for:
Approximate Date(s) of Hepatitis B Immunization:
Approximate Date(s) of DPT (Diptheria, Pertussis, Tetanus) Immunization:
Approximate Date(s) of Tetanus booster (Please indicate date of last booster):
Approximate Date(s) of Hib (Haemophilus influenzae type B) immunization:
Approximate Date(s) of Polio immunization:
Approximate Date(s) of MMR (Measles, Mumps, Rubella) immunization:
Approximate Date(s) of Chicken pox (Varicella) immunization:
Approximate Date(s) of Influenza (Flu shot) immunization:
Approximate Date(s) of Pneumonia (Pneumococcal) immunization:
Approximate Date(s) of Meningitis (Meningococcal) immunization:
Approximate Date(s) of Smallpox immunization:
Approximate Date(s) of Typhoid immunization:

I verify that all information provided in this Medical History Records Form is complete and accurate.

I give permission for HOBY to administer over-the-counter medications that I have approved above that may be necessary to treat minor conditions. I understand that if HOBY deems necessary, they will take me to a hospital or other medical facility for more intensive treatment. I understand that all HOBY staff, volunteers and HOBY, as an organization, are not liable for any adverse affects that may occur due to this medication. I also state that all the above information is complete and accurate and any misapplication of medication due to inaccurate, incomplete, or unreadable information is not the responsibility of HOBY.

By initialing here, I verify that all information provided in this Medical History Records Form is complete and accurate.
By initialing here, I verify that all information provided in this Medical History Records Form is complete and accurate.

Medication Verification Form for Physicians

This form is to be completed by the participant’s prescribing physician. If the participant has more than one prescribing physician, then each physician will need to complete a form. Please type or print legibly.

Please download and print the Medication Verification Form for Physicians by clicking here.


Please scan and email the completed form to Director of Operations, Drew Granucci at dgranucci@cthoby.org.


This link will also appear in your confirmation email. You should obtain a copy of the Medication Verification Form for EACH prescribing physician.

Policy for Use of Medication During a HOBY Event

If a minor or adult participant is required to take medication during a HOBY event, including the HOBY Leadership Seminar, he/she must comply with the following guidelines:

1. HOBY volunteers will not dispense prescription medication for participants during the event.

2. Any participant bringing prescription medication to the event must submit a doctor’s note or completed Physician Medication Verification Form to HOBY, preferably in advance or at the event check-in, detailing the following:

a. The name and type of medication.

b. The condition for which the medication is being prescribed.

c. Dosage information.

d. Attestation that use of the medication will not impair the participant’s ability to care for his/her own safety or the safety of others; increase the risk of harm to others; or cause dizziness and/or fatigue.

This information is necessary to provide medical personnel in the case of emergency and the participant is unable to communicate the information. All prescription medication must be submitted to HOBY in its original container as labeled by the pharmacy. HOBY will store required medications in a locked facility. The medications a participant may be allowed to keep in his/her possession is any asthma medications (inhalers, oral steroids, etc.), birth control pills, acne medication, any topical medications, allergy medications, medications for treatment of diabetes (insulin, etc.) and EpiPens, as well as any other prescription medication required by the doctor to be in their possession at all times. But there will need to be a doctor’s note completed and on file for all medication brought to the event, whether stored or not.

If a participant fails to advise HOBY that he/she is taking prescription medication, is not taking the medication as prescribed, and/or has stopped taking prescription medication, HOBY reserves the right to send the participant home at the participant’s guardian or parent’s expense.

3. If the participant has a medical condition that requires any assistance, the assistance must be provided or contracted directly by the participant or his/her parent/guardian. Under no circumstances will a HOBY volunteer help with dispensing medication. If help is needed on an emergency basis, emergency personnel will be contacted.

4. Proper administration and dosage of medication shall be the sole responsibility of the participant. HOBY will have no responsibility in seeing that the participant takes the medication as prescribed by the doctor.

5. Participants should only bring as much medication as will reasonably be needed during the event.

6. Participants are prohibited from sharing their personal medication with another participant. Conversely, participants are prohibited from accepting medication from anyone, other than HOBY medical staff.

7. Any participant bringing illegal drugs, narcotics, misused prescription drugs and/or mood altering substances or alcoholic beverages to a HOBY event, using them on HOBY premises or dispensing or selling them on HOBY premises will be subject to disciplinary action, including automatic expulsion from the event. The discharged participant will be responsible for any charges/fees incurred as a result of leaving the event early (i.e. change in airfare, taxi, etc.). HOBY has a very strict/no-tolerance policy when it comes to drugs.

You may click here to download the Policy for Use of Medication During a HOBY Event.

Health Insurance

Name of Primary Insurance Holder
By initialing here, I verify that all information provided in this Health Insurance Form is complete and accurate.
By initialing here, I verify that all information provided in this Health Insurance Form is complete and accurate.

Consent & Acknowledgement of Risk

through

IN CONSIDERATION of the right to attend and participate in the Activities described above, the Volunteer hereby:

1) Agrees to abide by all rules and regulations established by Hugh O’Brian Youth Leadership (HOBY);

2) Authorizes HOBY or any of its agents to provide, obtain, or authorize any reasonable incidental and/or emergency medical treatment for the Volunteer, in the event of the Volunteer’s illness, injury, or incapacity, and hereby accepts the responsibility to pay for such treatment;

3) Grants to HOBY for any purpose connected with promoting the purposes and goals of HOBY, but not for commercial exploitation, the right to use the Volunteer’s name, voice, likeness, verbal or written quotes in any writings, photographs, films, recordings, and social media postings of the Volunteer while he or she is participating in the Activities, and any biographical information submitted by the Volunteer to HOBY, and to use, reproduce, publish, and distribute the same;

4) Acknowledges that there is an element of risk involved in any activity involving travel outside of one’s own home or community; certifies that the Volunteer is physically, mentally, and emotionally capable of attending and participating in the Activities; assumes all risk of and financial responsibility for any loss or injury to the Volunteer or others that may occur as a result of the Volunteer’s negligence or misconduct; and indemnifies and holds HOBY harmless from and against any and all costs, claims, demands, charges, liabilities, obligations, judgments, executions, costs of the suit and actual attorneys’ fees incurred or suffered by HOBY as a result of, or arising out of, the Volunteer’s negligence or misconduct;

5) Agrees to immediately advise in writing the person in charge of the HOBY event and/or HOBY International of any injury, illness, or loss that occurs to the Volunteer during the event;

6) This Consent and Acknowledgment of Risk shall not be amended, supplemented, or abrogated without the written consent of HOBY’s International Office in Westlake Village, California;

7) Volunteer has read this Consent and Acknowledgment of Risk, and understands its contents.

By initialing here, I agree to the terms of the Consent & Acknowledgement of Risk.
By initialing here, I agree to the terms of the Consent & Acknowledgement of Risk.

Notice of Privacy Practices

WE PROVIDE THIS NOTICE TO DESCRIBE HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED. PLEASE REVIEW THE BELOW INFORMATION CAREFULLY AND IF YOU AGREE, PLEASE EXECUTE THE ATTACHED AUTHORIZATION.

We understand the importance of privacy and are committed to maintaining the confidentiality of your medical information. We may preserve the medical disclosure information (“medical information”) concerning you provided by you to HOBY for up to seven years. We use and retain these records to provide or enable health care providers to provide quality medical care to you in the event of an emergency. This notice describes how we may use and disclose your medical information. It also describes your rights, and our legal obligations with respect to your medical information.

A. How HOBY May Use Or Disclose Your Medical Information

HOBY collects health information about you and stores it in a file and on a computer. These files are the property of HOBY, but the information belongs to you. The law permits us to use or disclose your medical information for the following purposes:

1. Treatment. In the event of an emergency, we will provide medical information about you to the appropriate health care provider to provide for medical care for you. We may also disclose medical information to members of your family or others who can help you.

2. Awareness. We may also provide medical information about you to HOBY employees and/or volunteers to the extent necessary.

3. Alumni Activities. We may provide medical information about you to HOBY employees and/or volunteers in connection with alumni activities or events in which you may be a participant.

4. Limited Disclosure. We will limit the use and disclose of medical information about you as detailed below.

B. When HOBY May Not Use Or Disclose Medical Information

Except as described in this Notice of Privacy Practices, HOBY will not use or disclose health information which identifies you without your written authorization.

C. Your Health Information Rights

1. Request for Special Privacy Protections. You have the right to request restrictions on certain uses and disclosures of your health information by way of a written request specifying what information you want to limit and what limitations on our use or disclosure of that information you wish to have imposed. We reserve the right to accept or reject your request and will notify you of our decision.

2. Copy of Notice. You have a right to a paper copy of this Notice of Privacy Practices.

If you would like to have a more detailed explanation of these rights, or if you would like to exercise one or more of these rights, contact Hugh O’Brian Youth Leadership at 818-851-3980.

D. Changes to this Notice of Privacy Practices

We reserve the right to amend this Notice of Privacy Practices at any time in the future. Until such amendment is made, we are required by law to comply with this Notice. After an amendment is made, the revised Notice of Privacy Protections will apply to all protected health information that we maintain, regardless of when it was created or received.

E. Questions or Complaints

Questions or complaints about this Notice of Privacy or how HOBY maintains the medical information of your child or dependent should be directed to Hugh O’Brian Youth Leadership at 818-851-3980.

ACKNOWLEDGEMENT OF RECEIPT OF NOTICE OF PRIVACY PRACTICES

You may click here to download the Notice of Privacy Practices.

By initialing here, I hereby acknowledge that I agree to and that I received a copy of the Notice of Privacy Practices.
By initialing here, I hereby acknowledge that I agree to and that I received a copy of the Notice of Privacy Practices.

Social Media and the Code of Conduct

The Code of Conduct was created to provide guidance and expectations of behaviors on behalf of those serving HOBY. It was designed to protect HOBY, the Ambassadors, volunteers and local sites from behavior that could be detrimental to the effectiveness of the programs, the health and safety of Ambassadors and volunteers, as well has the reputation of HOBY as an organization. For the most part, the Code of Conduct is very straightforward and clear. However, it’s worth reviewing a few particular points.

First, much of the Code of Conduct applies beyond the 4 days of a seminar, the 8 days of WLC, the 6 days of ALA, or the one day of a CLeW or Alumni Event. Violations of the Code of Conduct which negatively impact HOBY; any programs; other volunteers, Ambassadors, or alumni can, and sometimes do, occur outside of specifically scheduled programs and events. For example, one of the bullet points in the Code states: “I will refrain from any form of personal abuse/attacks towards ambassadors, alumni, volunteers, staff, board and others, including verbal, physical and emotional abuse.” Clearly, such abuse can occur at any time. If HOBY International is notified of possible violations of the Code of Conduct, an investigation is conducted, documentation gathered and disciplinary action, if necessary, may be applied.

Recently, social networking has been a subject of some debate regarding the Code of Conduct. Social networking sites are wonderful communication and networking tools. They have helped keep HOBY stakeholders connected, motivated and inspired. In fact, the Official Facebook HOBY Fan Page, HOBY Twitter, and HOBY YouTube Channel are great examples. (If you haven’t joined yet, please do so at http://www.facebook.com/HOBY, http://www.twitter.com/HOBY, and http://www.youtube.com/HOBY.

However, cyber-bullying, inappropriate commentary and/or photos can be violations of the Code of Conduct, regardless of when they were posted. HOBY is not unique in this regard. Many employers will also act (including reprimands, suspensions, and terminations), in response to social network postings deemed inappropriate, even if the activity occurs outside company time. Employers and university admissions offices often look at social networking sites prior to accepting candidates. What is written, photographed, or recorded and posted can have a negative impact beyond what one might expect.

Obviously, HOBY does not have the staff, nor frankly, the inclination to search for and review postings and other activities by our vast network of volunteers and alumni. And fortunately, for the most part, we don’t have to do so. But when an issue is raised or a complaint filed, though a rare occurrence when considering the total number of HOBY volunteers and alumni nationwide, we do have an obligation to investigate and act accordingly. HOBY volunteers remain some of the most dedicated and inspiring people in the country, and for that we are grateful! If you have any questions regarding the Code of Conduct and its practical application, please do not hesitate to contact your DNP.

With this information in mind, HOBY recognizes that the line in using your own social media space as a HOBY volunteer or other stakeholder is often blurred when dealing with other HOBY stakeholders or the general public. We encourage members of the HOBY community to use social media as a way to stay connected, but remember that while social networking is fun and valuable, there are some risks you should keep in mind. In the social media world there is often no line between what is public and private, personal or professional. We've created these general social networking/media guidelines that are important for you to consider as you share your thoughts, views and perspectives—as a member of the HOBY community—in the virtual world.

Use Good Judgment

    • We expect you to use good judgment in all situations—that applies in the world of social networking/media as well.
    • Remember to know and follow the HOBY Code of Conduct.
    • Just as we work to maintain an environment in our programs that is positive, respectful and inclusive for all our stakeholders, let's work together to do the same in the social networking/media world.

Be Transparent

    • Even though you are a HOBY volunteer, unless you are specifically authorized to speak on behalf of the organization or one of its affiliates as a spokesperson, you should state that the views expressed in your postings, etc. are your own.
    • Be open about your affiliation with HOBY and the role/position you hold.

Don’t Share Everything

    • Do not publish, post, or release information that is considered confidential or not public. Online 'conversations' are never private!
    • If it seems confidential, it probably is. If you have any questions about what is considered confidential, check in with your Leadership Seminar Chair, Corporate Board President, or Director of National Programs.
    • To ensure your safety, be careful about the type and amount of personal information you provide to anyone, including fellow members of the HOBY community.
    • NEVER give out or transmit personal information of participants or fellow volunteers.

Show Respect

    • Please respect brand, trademark, copyright information and/or images of HOBY, its affiliates, and sponsors.
    • You may use photos and video (products, etc.) from events, but do so with the permission of those included in the material.
    • Please do not post pictures of others (participants, fellow volunteers, etc.) without their permission.

Scenario:

Q: You see something on YouTube/Facebook (or any other sharing/social media type site) regarding HOBY and you aren’t sure if the content is appropriate, what do you do?

A: Ask yourself the following questions:

Is it HOBY appropriate?

If a potential corporate donor was doing research to decide whether to give you a donation, and they saw this posting would it make a favorable impression?

If a foundation to which you applied for a grant was doing research to decide whether to give you a donation, and they saw this posting would it make a favorable impression?

If a potential GIK donor was doing research to decide whether to give you a GIK donation, and they saw this posting would it make a favorable impression?

If a school administrator or guidance counselor was doing research to decide whether to send a student to your seminar, and they saw this posting would it make a favorable impression?

If a potential volunteer was doing research to decide whether to volunteer with your site, and they saw this posting would it make a favorable impression?

If a potential ambassador was doing research to decide whether to attend your seminar, and they saw this posting would it make a favorable impression?

If a parent of a potential ambassador was doing research to decide whether to send their son or daughter to your seminar, and they saw this posting would it make a favorable impression?

If your answer to any of these questions is no, it shouldn’t be online. But it is. And you don’t have control over everything that is online and what gets video-taped and posted, but you do have control over what actually happens at your seminar or HOBY event. If you discover an unfavorable posting, it should be taken down immediately, or report it to your DNP for investigation.

Anything with the name of HOBY on it affects us all - all sites, HOBY International, WLC, TI, seminars in other countries - not just the particular site where the posting originated.

You may click here to download Social Media and the Code of Conduct.

Acknowledgement of Social Media and the Code of Conduct*

HOBY Code of Conduct

Hugh O’Brian Youth Leadership (“HOBY”) is committed to the highest ideals of youth leadership development and education and expects all representatives to act in a manner that contributes to the overall mission of HOBY, consistently reflects positively on the organization and follows HOBY policies. As a HOBY representative, I accept responsibility to represent HOBY with pride and dignity conducting myself in a professional manner and as a positive role model for HOBY program participants, alumni, volunteers, and the greater public. I agree to adhere to the following standards of conduct.

    • I will treat everyone with respect, dignity, patience, integrity and consideration. I will be fair, professional, and honest.
    • I will encourage participation of and respect for individuals of diverse backgrounds, cultures, and perspectives, and treat everyone equally.
    • I will maintain high standards of moral and ethical conduct that includes self control and responsible behavior. I will be a positive role model.
    • I will respect the property of hotels, universities, dormitories, dining facilities, and other venues.
    • I will ensure that HOBY is a positive experience for ambassadors, alumni, and volunteers, and will provide the highest quality event possible.
    • I will provide for the general welfare, health and safety of any ambassador or alumni in my charge during the course of my assigned duties.
    • I will abide by all HOBY rules, standards, policies and guidelines.
    • I will obey all local, state and federal laws.
    • I will refrain from the use of alcohol, tobacco products and profane language while serving HOBY, particularly while in the presence of youth.
    • I will refrain from any form of personal abuse/attacks towards ambassadors, alumni, volunteers, staff, board, and others, including verbal, physical and emotional abuse.
    • I will not engage in disloyal, disrespectful, and detrimental conduct to HOBY, including, but not limited to, disloyal, disrespectful, and detrimental conduct by e-mail and on the internet.
    • I understand that I am only authorized to represent HOBY as specifically indicated in my position description, or as directed in a written authorization signed by my respective Director of National Programs, or as approved by the President/CEO and/or the Board of Trustees.
    • I will perform all duties and responsibilities in a timely and professional manner.
    • I understand that HOBY discourages relationships of a romantic or sexual nature between supervisors and those they supervise or volunteers and those they serve. I agree to maintain appropriate relationship boundaries during the course of my volunteer activities/work and agree to speak with a supervisor/staff member should any relationship develop which makes it difficult for me to remain objective and fulfill my obligations.

You may click here to download the Code of Conduct.

High School Recruitment

CT HOBY would like all schools to register their ambassador(s) by February 1.

My school has already registered a student.*
Name of school official responsible for registering a student to HOBY
Estimated Registration Date (if a student hasn't been registered yet)
Name of the student representing my high school
Name of second student attending from my high school (if applicable)*

Frequently Asked Questions

The following are our Frequently Asked Questions from participants and parents.


Q: What is HOBY?

A:Hugh O’Brian Youth Leadership (HOBY) is a non-profit organization committed to inspiring and developing our global community of youth and volunteers to a life dedicated to leadership, service, and innovation. Founded in Los Angeles, California in 1958 by actor Hugh O’Brian, HOBY programs provide youth selected by their schools to participate in unique leadership training, service-learning and motivation-building experiences. HOBY also provides adults with opportunities to make a significant impact on the lives of youth by volunteering. Over 4,000 committed HOBY volunteers plan and execute the programs each year, serving both at the local HOBY affiliate level and on HOBY’s Board of Trustees. Due to the selfless efforts of volunteers and the contributions of generous donors, nearly 10,000 students participate in HOBY programs annually. Today, over 450,000 proud alumni make HOBY stronger than ever. HOBY alumni are leaders in their schools and communities, throughout the United States and the world, making a difference for others through service.

Q: What is the purpose of the state leadership seminar?

A: The seminar supports the primary objectives of Hugh O’Brian Youth Leadership: motivate and empower individuals to make a positive difference within our global society through understanding and action based on effective and compassionate leadership; to interface these potential leaders with recognized leaders in business, industry, government, science, education, and the professions through give and take workshops; to stimulate opportunities for these young people to demonstrate their leadership abilities when they return home for betterment of community and country.

Q: How are students selected to attend a HOBY Leadership Seminar?

A: Each October, the National Association of Secondary School Principals sends nomination materials to all 22,500 public and private high schools in the United States. Each school selects an outstanding sophomore, based on their leadership potential, to represent their school at their state seminar. Since only one student is selected, it is an honor to be recognized as a leader among peers.

Q: What do students receive by attending their state leadership seminar?

A: Known as HOBY’s flagship program, the Leadership Seminar is designed for seminar attendees, or HOBY Ambassadors as they are called, to recognize their leadership talents and apply them in becoming effective, ethical leaders in their home, schools, workplace and community. The high level of energy, encouragement and motivation as well as the interaction with peers, panelists and volunteers are important elements in nurturing the students’ future leadership roles. In addition, students participate in hands-on leadership activities and meet state leaders in such as areas as business, government, education, media and the non-profit sector. Ambassadors will also participate in a service learning community project. Throughout the seminar, students build new friendships and networks for the future.

Q: What are the benefits after attending a HOBY Leadership Seminar?

A: Many Ambassadors return home with a new vitality, a greater sense of purpose, and a new set of resources that they can use to make their schools and communities better places in which to live. With this new enthusiasm, HOBY Ambassadors can create a ripple effect of social responsibility in their communities. Ambassadors are asked to become part of HOBY’s commitment to the “President’s Summit for America’s Future”. By undertaking a community service project(s) involving at least 100 hours, they have the opportunity to join 10,000 other HOBY Ambassadors in making a difference in your school, community, place of worship, or other “environment”. Alumni can continue their involvement by attending Alumni functions, volunteering for the annual leadership seminar, or teaching at a one-day Community Leadership Workshop (CLEW) held in local communities. HOBY seminar attendance can be added to resumes and college applications. Alumni are eligible to receive Ambassador Leadership Scholarships from various colleges and universities to help fund higher education through graduate school.

Q: Who is Mike Roy?

A: Mike is the Connecticut Leadership Seminar’s chairperson who leads an all-volunteer committee. He is a 2009 CT alum, volunteering with the seminar ever since in various positions. This is his second year as chair after already serving as Vice Chair and Director of Operation, as well as a junior staff member. Mike has additionally served as a member of the World Leadership Congress held in Chicago since 2012 in various positions. In his professional life, he serves as an Americorps member for City Year in Seattle.

Q: What kind of supervision is provided at the leadership seminar?

A: The seminar is chaperoned by qualified adult male and female facilitators who stay at the facility 24 hours a day. Most facilitators were HOBY Ambassadors and now volunteer their time. Groups of 8-10 Ambassadors are organized into small teams led by an adult facilitator.

Q:How can I follow what is happening at the seminar?

A: The seminar committee will be posting updates to our Facebook Fan Page and Twitter accounts all weekend, beginning Thursday afternoon. Become a fan of HOBY Connecticut on Facebook at http://www.facebook.com/hobyct and follow us on Twitter at http://www.twitter.com/cthoby .

Q:What transportation arrangements have been made?

A: We are unable to provide transportation to and from the seminar. It is the parent’s responsibility.

Q:What are the accommodations like?

A: Participants will be assigned to dormitory rooms with two to room on floors reserved exclusively for the seminar. Students will need to bring their own towels, pillows, bed linens, and toiletries. Everyone will receive breakfasts, lunches, and dinners. Students should have eaten breakfast prior to arrival on Friday. On the Medical History Records Form, please indicate any special dietary considerations, including vegetarianism, and we will do our best to accommodate you.

Q:What if I need to take medication while I am at the seminar?

A: Please provide information about your medication on the Medical History Records Form and bring the Physician Medication Verification Form with you to the seminar (documents are included in this packet). Make sure to read and comply with the Policy for Use of Medication During a HOBY Event.

Q:What if I am unable to attend the seminar?

A: If circumstances arise that prevent you from attending, we want to give another student from your school the opportunity to attend. Please notify the person at your school who selected you, and call HOBY Connecticut at (860)304-6374.

Q:Who may I contact should I have additional questions?

A: Additional questions or concerns should be directed to Mike Roy at mroy@cthoby.org or call (860)933-5243. You can also contact our Director of Staff Natalie Gaudette at (860)884-0250 or ngaudette@cthoby.org

Donations to Connecticut HOBY

Connecticut HOBY is only made possible through contributions from the community. We have an annual budget for existing programs that exceeds $30,000. However, we expend no money for the monthly rent or lease of an office, and have no paid staff or administrative personnel, since our entire staff is comprised of volunteers. One hundred percent of our funds are used for the charitable purposes of our programs. It is our sponsors that make these wonderful programs possible.


Sponsorship of high school sophomores ensures that there is no cost to the students, their parents, or the high schools involved in HOBY programs. This is because our sponsors realize that leadership potential can be found in every corner of our state, and the ability to pay should not be a consideration. They also realize that sponsorship of these students leads to the betterment of their own local communities as these students give back to the community after going through a HOBY program.


HOBY depends heavily on the generosity of our supporters and even our volunteers. Even as we strive to keep our costs low, we feel the effect of increased lodging, transportation, and food expenses. Our cost per student has risen to more than $350 per student.


Some of our volunteers only come in for the weekend. Others put in as many hours to HOBY as they do their full time paid jobs. While the time that each volunteer contributes is invaluable, it still takes dollars to make sure our seminar can happen at the level that has made it a nationally recognized program for more than a decade.


If you would like to make a donation now, please go to www.cthoby.org and click the PayPal link at the bottom.

Junior Staff: The Junior Staff Team this year is setting a collective fundraising goal which will amount to an average of $300 per Junior Staff member. All Junior Staff members (volunteers under 21) are expected to contribute to this goal. If we meet the collective fundraising goal as a team, all accepted members will be able to attend. If, however, we do not meet this collective goal, Junior Staff members who have not met the $300 average will be at risk of losing their place at the seminar.*
$

+21 Staff:

Although your donation is suggested, please feel free to ask your Director how you can help the fundraising efforts.

I would like to donate via Paypal at this time:*
$

Key Deposit

While on the University of Bridgeport's campus, every individual will be provided a key to their room and access card to the building. Lost keys are the responsibility of the individual, and normally cost $60 to replace.

CT HOBY requires a $20 refundable deposit for staff. At the end of the event, if you return your key and access card, we will return your $20 to you in person. If you lose your key or access card, you will be responsible for the additional cost incurred.

Final Checklist

Please make sure you honestly consider these questions before you submit your application. :)

I can attend the entirety of CT HOBY 2017 from 5pm on Thursday May 31, 2018 through 5pm on Sunday June 3, 2018*
When is your potential conflict?*
We will do our best to help organize carpools, but please have a plan in case nobody lives near you.
I understand that my school must be represented by a sophomore ambassador in order for me to attend.*
I am willing to contribute to the collective funraising goal to help our group raise the amount set. I understand my inability or failure to contribute adequately to the group fundraising goal may result in removal of my position and participation as a member of the Junior Staff.*
I have applied to be a HOBY volunteer online at https://reg.hoby.org/HOBYVolunteerApplication/*
Do you have the necessary health to function for the seminar in its entirety?*

Adult staff applicants are asked to download the Facilitator Handbook and review it in advance of the staff orientation and training. The Facilitator Handbook is available for download here.

By signing below, I certify that all statements made and information provided in this application are true and complete to the best of my knowledge. This signature serves to validate and acknowledge the proper submission of travel information, medical history record, health insurance information, consent and acknowledgement of risk, acknowledgement of the notice of privacy practices, agreement to the Code of Conduct, and the Social Media supplement to the Code of Conduct as well as all answers contained herein this application.

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