Volunteer Application

Thank you for your interest in our organization!

We are deeply committed to making a meaningful impact in the lives of the young people we serve. That’s why we seek volunteers who are trustworthy, dependable, patient, and genuinely called to the ministry of serving children and youth.

Please note that all applicants are required to complete a background check before being accepted into our program.

Name

First NameLast Name

Date of Birth

Date

Gender

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

Format: (000) 000-0000.

E-mail

example@example.com

How did you hear about this volunteer opportunity?

What is your highest completed level of education?

Do you have a valid driver's license?

Are you willing to submit a background check?

Which role are you interested in serving?

What experience or qualifications make you a strong fit for this role?

What strengths or skills would you contribute to our program?

Why are you interested in volunteering with us? What motivates you to serve in this capacity?

Please describe your availability:

Please supply three character references:

(A minimum of two references must be non-related)

Reference #1

Name

First NameLast Name

Relationship

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Reference #2

Name

First NameLast Name

Relationship

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Address

Street Address

Street Address Line 2

CityState

Zip CodeCountry

Reference #3

Name

First NameLast Name

Relationship

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Address

Street Address

Street Address Line 2

CityState

Zip CodeCountry

Have you at anytime ever:

Been convicted of or pleaded guilty or no contest to any crime?

Please explain:

Participated in or been accused, convicted, or pleaded guilty or no contest to abuse or any sexual misconduct?

Please explain:

Had a restraining order filed against you?

Please explain:

Are you aware of:

Having any traits or tendencies that could pose any threats to children, teens or others?

Please explain:

Any reason why you should not work with children, teens or others?

Please explain:

Do you use illegal drugs or substances?

Please explain:

Do you currently smoke or vape?

Please explain:

I understand that Urban City Impact is relying on the accuracy of the information I provide in this application. I authorize the organization to contact any individuals or entities listed, and I give those individuals or entities permission to share information, opinions, and impressions regarding my background and qualifications. I voluntarily release both Urban City Impact and those contacted from any liability related to the exchange of this information. I certify that the information I have provided in and with this application is true and correct to the best of my knowledge.

Signature