Volunteer Application Form

Volunteer Application Form

Must be at least 16 years of age to appy
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
E-mail
example@example.com
Date of Birth:*

MonthDayYear
Date
Driver's License:
VOLUNTEER LOCATIONS:*

Dundalk, MDAnne Arundel County
Highest Level of Education:

GEDHigh SchoolSome CollegeBachelor's DegreeMaster's DegreeOther
Do you have any past or present volunteer experience?

NoYes
If yes, please describe
Do you have experience with youth?

NoYes
If yes, please describe
Is your community service required? (School, work, etc.)

YesNo
Availability:*

MondayTuesdayWednesdayThursdayFridaySaturdaySunday
Check all areas in which you are interested in volunteering*

MentoringTeachingFundraisingFront Desk HospitalityChildcareEvents
Emergency Contact:*

First NameLast Name
Emergency Contact Phone:*
Please enter a valid phone number.
Current Employer:

First NameLast Name
Employer Phone Number:
Please enter a valid phone number.
Do you currently use illegal drugs?*
Have you ever been convicted of a criminal offense?*
Have you every been convicted of child abuse or neglect or is there a pending criminal charge against you for child abuse or neglect? (includes child pornography) *
Are there any other facts or circumstance involving you or your background that would question your ability to be entrusted with the supervision, guidance and care of minors?*
Comments
Understanding and Authorization

I certify that all the answers on the application and any attachments are true and complete to the best of my knowledge. I also certify that I have not withheld any pertinent information. I agree that in the course of considering my application, you may inquire to verify information considering my background. I specifically authorize you to investigate all statements in this application. I authorize educational institutions, employers and references listed to give you any
and all information concerning my education, employment and fitness to work with children and young people. I further agree to release and hold harmless Evolve KidsCare, institutions and references listed above and any law enforcement agency, from all liability and any damage that may result from furnishing this information to you.
Signature*

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Date*

MonthDayYear
Date
APPLICANT RELEASE AND AUTHORIZATION FORM

I herby authorize Evolve KidsCare or other authorized representatives of the company bearing this release to obtain and release any information pertaining to my background, including any of the services note below, for employment or volunteer purposes. I hereby fully release and discharge my prospective employer, other authorized representatives of the company, or other source providing
information from all claims and damages arising out of or relating to any investigation of my background for said purposes.
Applicant Signature*

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Date*

MonthDayYear
Date
Should be Empty: