Young Writer Retreat Parent Volunteer Form

Retreat Parent Volunteer Form

We're looking for parent volunteers to help us with some different responsibilities at the retreat. Please check the Young Writer Retreat website for more information about these roles. By filling out this form, you are consenting to us running a background check on you.
Name*

First NameMiddle NameLast Name
Please list any other names used (if relevant)
Date of Birth*

MonthDayYear
Date
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone Number*

Area CodePhone Number
Social Security Number (for Background Check)*
What is the name of your child (or children) in YWW? Please also mention if they're attending the YWW Retreat or not.*
Have you been to a YWW event before?*
At any time in your life, have you been convicted of a crime?*

YesNo
If so, please explain briefly, including when this occurred.
Please list the name and phone number of two character references.*
In connection with volunteering with The Young Writer, notice is hereby given that a consumer report and/or investigative consumer report may be obtained from a consumer reporting agency for employment purposes. The reports may contain information about you relating to your criminal history, credit history, driving and/or motor vehicle records, education or employment history, or other background checks.

You have the right, upon written request made within a reasonable time after the receipt of this notice, to request disclosure of the nature and scope of any investigative consumer report prepared by contacting The Young Writer and Protect My Ministry 14499 N. Dale Mabry Hwy., Suite 201 South, Tampa, FL 33618; Phone: 1-800-319-5581. For information about Protect My Ministry's privacy practices, see www.protectmyministry.com.

The scope of this notice and below authorization is not limited to the present and, if you are hired, will continue throughout the course of your volunteering and allow The Young Writerto conduct future screenings for retention, promotion or reassignment, as permitted by law and unless revoked by you in writing.
Acknowledgement & Authorization

By signing below I hereby authorize the obtaining of consumer reports and/or investigative consumer reports by The Young Writer at anytime after receipt of this authorization and throughout the course of my volunteering, if applicable.
Signature*

Clear
Today's Date*

MonthDayYear
Date
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