VESSELS OF HONOR INTERCESSORY PRAYER MINISTRY (VOHIPM)DBA: VESSELS OF HONOR

VESSELS OF HONOR INTERCESSORY PRAYER MINISTRY (VOHIPM)DBA: VESSELS OF HONOR
VOLUNTEER BACKGROUND AUTHORIZATION FORM
*Program for which you are volunteering:
LEGAL NAME AS IT IS LISTED ON YOUR DRIVERS LICENSE OR GOVERNMENT ISSUED PHOTO IDENTIFICATION (ID)
Name

First NameMiddle Name at Birth Last Name
Date of Birth

MonthDayYear
Date
Social Security Number
Marital Status:

SingleMarriedSeparatedDivorced
Valid Driver’s License / State ID#
Valid Driver’s License / State ID#
Address

Present Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
How long Have you been at this address?
Telephone Number#
Telephone Number#
Email Address
example@example.com
Gender:

MaleFemaleTransgenderGenderqueerOther
Race:

African AmericanAsianCaucasianHispanicOther
I hereby authorize The VOHIPM to conduct a complete criminal history check as a basis of my placement as an employee or a volunteer with the organization. I understand and agree to immediately report any changes in my criminal history to the corporate office of VOHIPM.
Volunteer Signature:

Powered by Jotform SignClear
Date

MonthDayYear
Date
Print Name:
Should be Empty:

VOLUNTEER BACKGROUND AUTHORIZATION FORM