Team Focus Indiana - Volunteer Application

Volunteer Application

The following is my true and complete legal name and all the following information is true and correct to the best of my knowledge.
Name *

First Name Last Name
Home Mailing Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number *
Please enter a valid phone number.
Email *
example@example.com
Social Security *
Birthday *

Month Day Year
Date
Driver's License Number *
Race: *
Driver's License State *

Street Address

Street Address Line 2

State / Province
Relationship Status: *

Single Married Widowed
Name of Spouse *

First Name Last Name
Are you employed? *

Yes No
Employer *
Work Phone *
Please enter a valid phone number.
Work Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

References

The references should be of an institutional nature (i.e. former employer or other organizations at which the individual has volunteered). Do not list personal friends or relatives. The person serving as a reference should also have known you for at least 12 months. Please do not list staff of Team Focus.
Name *

First Name Last Name
Relationship *
Phone Number *
Please enter a valid phone number.
How long has this person known you? *
Number of years.
Name *

First Name Last Name
Relationship *
Phone Number *
Please enter a valid phone number.
How long has this person known you? *
Number of years.

We apologize for needing to ask the following questions which may cause embarrassment for some. We would not do this if it were not absolutely necessary to protect the children and the integrity of Team Focus itself.
Have you ever been convicted of, pleaded guilty to or been involved in child abuse or a crime involving actual or attempted sexual molestation of a minor? *

Yes No
Have you been convicted of or pleaded guilty to a crime other than traffic violations? *

Yes No
Do you have any personal, emotional or other restrictions that could limit you serving or that others should be aware of? *

Yes No
If yes, please describe: *

I, First Name Last Name, UNDERSTAND THAT THIS INFORMATION WILL BE MADE AVAILABLE ONLY TO THE RESPONSIBLE AND APPROPRIATE STAFF AND MINISTRY LEADERS OF TEAM FOCUS. IT IS TREATED CONFIDENTIALLY, LOCKED AND COMPUTER ACCESS TO DATA RESTRICTED AND CONTROLLED. I AUTHORIZE ANY REFERENCES IN THIS APPLICATION TO GIVE YOU ANY INFORMATION (INCLUDING OPINIONS) THAT THEY MAY HAVE REGARDING MY CHARACTER AND FITNESS FOR WORK WITH THE YOUNG MEN OF TEAM FOCUS.
Signature *

Clear
Date *

Month Day Year
Today's Date
Should be Empty:

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Volunteer Application