Annual Confirmation of Youth Volunteer Status and Information Update

ANNUAL CONFIRMATION OF YOUTH VOLUNTEER STATUS AND INFORMATION UPDATE
I understand it is the policy of Delta Sigma Theta Sorority, Inc. that volunteers in Delta's youth activities must undergo background screening every three years to remain a volunteer. In the years that a background check is not required, I understand that I must confirm that my personal information has not changed from the prior year. If any information has changed, I understand that i must provide the updated information.

I also agree that once accepted as a volunteer, I must notify the Chapter immediately if I am the subject of any pending charges and/or convicted of an offense at any time after submitting this application or being cleared as a volunteer. I also further acknowledge that a volunteer with pending charges relating to abuse, neglect, a drug related offense, any crime with the involvement of youth, termination from a paid or volunteer position related to misconduct with a youth, any crime involving violence or recent history of substance abuse, will be terminated as a volunteer.
Updated Information: Any changes to my name, address, phone, email, driver’s license or state issued identification number is listed below. I have also listed in the box below and pending charges and/or convictions of a criminal offense against me since being cleared as a volunteer.
Please initial your confirmation of the following: I have no updated information or any pending charges and/or convictions of a criminal offense against me since being cleared as volunteer from the prior year.
Signature

Clear
Print Name
Date

MonthDayYear
Date
Year of Initial Volunteer Application
Email
example@example.com
Should be Empty:

ANNUAL CONFIRMATION OF YOUTH VOLUNTEER STATUS AND INFORMATION UPDATE