Volunteer Eligibility & Screening Form
To ensure the safety of the families we serve, eligibility screening is required.
Eligibility Questions
Are you 18 years or older?
*
Yes
No
If under 18, parental consent received?
*
Yes
No
Have you ever been convicted of a felony?
*
Yes
No
If yes, please explain:
*
Willing to complete a background check?
*
Yes
No
Commit to professional conduct standards?
*
Yes
No
Reference Information
Reference Name
*
Relationship
*
Phone
*
Format: (000) 000-0000.
Email Address
*
example@example.com
Emergency Contact
Name
*
Relationship
*
Phone
*
Format: (000) 000-0000.
*
I agree to volunteer policies and code of conduct.
Full Legal Name
*
Signature
*
Date
*
-
Month
-
Day
Year
Date
Submit
Should be Empty: