Total Legacy Foundation Volunteer Application

Total Legacy Foundation Volunteer Application

Please complete all sections to apply as a volunteer. All information is confidential and used solely for volunteer screening.
Contact Information
Full Name*

First NameLast Name
Date*

MonthDayYear
Date
Home Address*

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Telephone*
Please enter a valid phone number.Format: (000) 000-0000.
Email Address*
example@example.com
Date of Birth*

MonthDayYear
Date
Valid Driver’s License Number*
Emergency Information
Special Needs/Conditions
Emergency Procedures (if applicable)
Emergency Contact Information
Emergency Contact Name*
Relationship to Emergency Contact*
Emergency Contact Telephone*
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact Address*
Availability to Volunteer
Monday Availability
Tuesday Availability
Wednesday Availability
Thursday Availability
Friday Availability
Weekend Availability
Start Date

MonthDayYear
Date
Hours Needed
Completion Date

MonthDayYear
Date
Equal Employment Opportunity

(Optional)
How would you designate yourself racially and/or culturally?

CaucasianAfrican AmericanAsian or Pacific IslanderNative American or Alaskan NativeMulti-culturalOther
References (First Reference)
Name (Reference 1)*
Reference 1 Type

PersonalProfessional
Title/Relationship (Reference 1)*
City, State (Reference 1)
Reference 1 Phone number
example@example.com
References (Second Reference)
Name (Reference 2)*
Title/Relationship (Reference 2)*
City/State (Reference 2)
Phone number 2 E-mail
example@example.com
Background and Criminal History
Have you ever been convicted of a crime?*

YesNo
If yes, please explain when, where, and the nature of the offense:
Are there any criminal charges against you currently?*

YesNo
If yes, please explain when, where, and the nature of the offense:
Have you ever had a personal protection order against you?*

YesNo
If yes, please explain when, where, and the nature of the offense:
Have you ever been involved in the abuse or neglect of a child or adult?*

YesNo
If yes, please explain when, where, and the nature of the offense:
Have you ever been involved with a protective service agency?*

YesNo
If yes, please explain when, where, and the nature of the offense:
Applicant Statement and Authorization
The information contained in this application is correct to the best of my knowledge and is hereby given for any investigation that may be necessary. I understand that misleading or untruthful information on this application may result in my dismissal from any volunteer job consideration. I authorize my references listed in this application to relay information they may have regarding my character and fitness for work on behalf of children. I release all such references from liability for any damage that may result from furnishing such evaluations to you, and I waive any right that I have to inspect references provided on my behalf.
Should be Empty:

Total Legacy Foundation Volunteer Application

Contact Information

Emergency Information

Emergency Contact Information

Availability to Volunteer

Equal Employment Opportunity

References (First Reference)

References (Second Reference)

Background and Criminal History

Applicant Statement and Authorization