Haven Volunteer Application

Volunteer Application
Thank you for your interest in volunteering at The Haven! The Haven's mission is to be a place for Orting teens to feel safe, have fun, and hang out with friends. As a Haven Volunteer you will need to demonstrate maturity, initiative, problem solving skills, and the desire to help those around you, specifically the teens we serve. By completing and signing this application you are agreeing to have your information submitted for a background check.

All fields with an ( * ) must be filled in.
Name*

First NameMiddle NameLast Name
Maiden Name, Previous Married Name, or any other names you've gone by
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Birthdate*

MonthDayYear
Teen Time is for 6th - 12th grade Students
Gender*
Physical Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Is your physical and mailing address the same?*

YesNo
Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Contact Name*

First NameLast Name
Emergency Phone*
Please enter a valid phone number.
Relationship to you*
Do you have experience working with youth (any age)? Explain Below*
Why are you interested in becoming a volunteer at The Haven?*
How did you hear about us?*
Select all certificates that apply

CPRFirst AidLifeguardFood Handlers PermitOther
Have you ever been convicted of a Felony in the last 10 years?*

NoYes
Have you ever been charged with child neglect or abuse in the last 10 years?*

NoYes
Are there any pending criminal charges against you?*

NoYes
A conviction may not necessarily disqualify you. If you selected "yes" to any of the above questions please list offense, date of conviction, and jurisdiction.
What kind of Volunteering interest you the most? Select all that apply*

Working Directly with the TeensBehind the scene (Planning, Setup, Clean-up)CookingArts / Creative ActivityEvents / Fundraising / BoothsAdmin Tasks / Data EntryOther
Available Schedule*

Weekday Daytime (9am-5pm)Weekday Evenings (5pm-10pm)Teen Time (Wed 2:30pm-5:30pm)Teen Time (Thurs 2:30pm-5:30pm)Teen Time (Fri 2:30pm-5:30pm)Weekend (Saturday / Sunday)Other
Please read the following carefully before signing this application;

I understand that this is an application and not a commitment or promise to volunteer. I certify that I have and will continue to provide information throughout the selection process that is true, and complete to the best of my knowledge. I certify I have and will answer all questions to the best of my ability and that I have not and will not withhold any information that would unfavorably affect my application for a volunteer position. I understand that information contained on my application will be verified, if necessary, by contacting any person or organization that may have information concerning me. I release and agree to hold harmless from liability any person or organization who provides information. I understand that misrepresentations or omissions may be cause for immediate rejection as an applicant for a volunteer position, or my termination as a volunteer.

I confirm the information contained in this application is correct to the best of my knowledge. I hereby authorize Opportunity Center of Orting dba The Haven and its designated agents and representatives to conduct a comprehensive review of my background. I understand that the scope of the background check may include, but is not limited to the following areas; verification of identification and criminal history records from any criminal justice agency in any or all federal, state, and county jurisdictions.
Upload copy of your drivers license*

Cancelof
Print Full Name*
Date*

MonthDayYear
Signature*

Powered by Jotform SignClear
Please verify that you are human*
Should be Empty: