ELC Volunteer Registration Form

Client Advocate - Program leader Staff Application
Client Advocates (CAs) are program leaders. They are the ones primarily responsible for the center's daily activities. CAs lead the lessons, ensure client safety, defuse conflict, are responsible for center operations and policy compliance. As site leaders CAs oversee clients' interactions with other staff, volunteers, and life skill coaches.

CAs are responsible for opening and closing/securing the center. Client check in and exit.

CA hours are 2:45 pm - 6:15 pm.
Full Name*

First NameLast Name
Please select your current age range*

Over 18 under 21Over 21 under 35Over 35
E-mail*
example@example.com
Phone Number*
Can this number receive texts?*

YesNo
Have you worked with youth, high school age or young adults in the past?*

YesNo
What was the name of the organization   Type a label
How long did you work or volunteer there   Type a label
Why did you leave   Type a label.
May we contact them for a reference?*

YesNo
If yes please give contact information: name, title and phone number of reference
If no, please explain
Have you ever been let go, fired or asked to leave a position, working with children, youth, elderly or other vulnerable persons/ populations?*

YesNo
If yes, please explain. Include dates and details of dismissal
Have you ever had an accusation of inappropriate or violent conduct made against you*

YesNo
If yes, explain. Include date, details and outcome of accusation. i.e. were criminal or civil charges filed or was the accusation dismissed
What days would you be available?*

TuesdaysWednesdaysThursdays
Please list a non family member reference*

First and Last nameRelation
Reference phone number*
Please enter a valid phone number.
Years known*
Have you ever had any non motor vehicle arrest or convictions*

YesNo
if yes list offense and year of conviction / arrest
Do you have any current or pending criminal charges. Are you currently on probation*

YesNo
if yes list offense and year of conviction / arrest
if on probation list name and contact number of probation officer
Have you ever been instructed not to have contact with children or do you have a history of sex offender registration?*

NoYes
To the best of my knowledge the above information is true and accurate. *

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Client Advocate - Program leader Staff Application