• Safety Application Form for Volunteers

    Safety Application Form for Volunteers

    CONFIDENTIAL
  • This application should be completed by all applicants for any position involving the supervision of children or students. This is not an employment application. The purpose of this form is to assist in the creation of a safe environment for children or students who participate in the programs of Foundation or use Foundation facilities.

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  • Because we care for children and desire to protect them, please answer the following questions. We understand that the answers to these questions may be private and deeply personal, and we will protect your privacy in every possible context. It is the position of Foundation that suspicions or allegations of child abuse or neglect will be reported to relevant state authorities. 

  • REFERENCES

  • Each applicant must submit the names and phone numbers of at least one professional reference, one personal reference, and one family member. The professional references should be familiar with the quality of the individual’s work. If applicant has never held outside employment, a volunteer supervisor will suffice. One of these references should be a person of the opposite sex. Please contact these references and inform them an authorized Foundation staff person will be contacting them.

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  • Volunteer Statements and Agreed Code of Conduct

  • RELEASE

  • I authorize Foundation to contact all individuals, organizations and references listed on this Safety Application Form in order to verify the information I have provided. I agree to release from liability any person or organization providing information related to me, including those persons I have listed as references, as well as contact persons from my previous volunteer work or employment with children.

    I specifically authorize Foundation to undertake a criminal background check concerning my past.

    I understand and agree that any information received from the background check and application verification will not be disclosed to me except as required by law, and I hereby waive any right I may have to inspect any information provided about me by any person or organization identified by me on this form.

    By signing this form, I certify and affirm that the information I have given on this form is true, complete and correct in all respects.

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