Cornerstone Volunteer Application
OFFICE USE ONLY - Background Check/Application Approved
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Month
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Day
Year
Date
Application denied
Missing background check
Incomplete application
Other
Name
*
First Name
Middle Name
Last Name
Birthdate
*
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Month
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Day
Year
Date
Your Age Category
*
14 and under
15-17
18+
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Primary Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Alternate Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email address
*
example@example.com
Preferred method(s) of contact
Phone
Email
Text
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Volunteering Information
Which Cornerstone locations or programs are you interested in volunteering for? Please check all that apply. PLEASE NOTE THAT VOLUNTEERS AGED 14 AND UNDER MUST VOLUNTEER WITH A PARENT OR GUARDIAN.
*
Cornerstone Resale (includes store and donation processing center)
Case Management (includes mentoring, budgeting, job assistance programs) *must be at least 21 years of age
Cornerstone Events (Back to School, Christmas event, etc.)
Special skills or talents
Are you bilingual?
*
No
Yes
If yes, what languages do you speak?
Employer/Occupation
*
Physical Limitations
*
Are you a member of a service organization?
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No
YMSL
NCL
NJHS/NHS
Other
How did you hear about Cornerstone?
*
Church Membership
Who is Jesus to you?
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Emergency Contact
*
First Name
Last Name
Emergency Contact Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency Contact Relationship to you
*
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***YOU WILL RECEIVE A SEPARATE EMAIL TO COMPLETE BACKGROUND CHECK ***
***Applicants 18 years and older will receive a separate email with a link to complete the background check***
Full Legal Name
*
First Name
Middle Name
Last Name
Aliases, Including Maiden Name (if applicable)
*
TX Driver's License Number (if from another state, please indicate state)
*
Have you ever been convicted of a felony or misdeameanor?
*
Yes
No
If yes to felony/misdemeanor, please explain. Otherwise, n/a
*
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Release of Liability
Please read each statement carefully and enter your initials in the box below the statement (For those under 18, a guardian must complete).
I verify that the information provided in this application is complete and accurate. I will hold all information regarding Cornerstone Assistance Network of North Central Texas clients to the utmost confidentiality. (initial below)
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I hereby waive forever for myself, heirs, executors, and administrators and assigns, hereby release, indemnify and hold harmless Cornerstone Assistance Network of North Central Texas. (initial below)
*
I hereby waive forever for myself, heirs, executors, and administrators and assigns, hereby release, indemnify and hold harmless the organizers, directors and supervisors of all volunteer activities from all connection with any volunteer effort in which I participate. (initial below)
*
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By continuing to volunteer with CNCT, I acknowledge and expressly agree to the following (please initial below each statement)(For applicants under 18, a parent or guardian must complete).
That any claim or dispute arising out of any Accident or Occurrence will be resolved exclusively through alternative dispute resolution procedures, including final and binding arbitration. (initial below)
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The arbitrator shall issue a written decision and award, if any, stating the reasons therefore. The decision and any award shall be final and binding. No contractual relationship is hereby created other than this agreement to arbitrate. (initial below)
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I give Cornerstone Assistance Network of North Central Texas permission to contact the references provided in this application and complete a background check (for applicants 18 and over). (Initial below)
*
Cornerstone Assistance Network of North Central Texas staff members have permission to utilize photographs or videos of me for publicity or training purposes. (initial below)
*
I give Cornerstone permission to utilize my provided contact information, including email, to reach out to me regarding opportunities and events, as well as for conducting background check.
*
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ELECTRONIC SIGNATURE - By typing your full name below, you attest that all information you have provided and answers you have given in this application are true to the best of your knowledge.
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Type Full Name
Submit
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