Grace Chasers Volunteer Application

Full Legal Name*

First NameMiddle NameLast Name

Current Drivers License Number (A photocopy of license must accompany application)*

Upload picture of your DL here:

Upload a File

Please also upload a current photo of yourself (headshot).

Upload a File

Gender

MaleFemale

Current Age*

Marital Status*

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Email*

Confirmation Email

Best Contact Phone Number*

Area CodePhone Number

Occupation*

Name of Employer*

Number of Years at Current Employer*

Emergency Contact*

Relationship *

Best Phone Number for Emergency Contact*

Area CodePhone Number

T-Shirt Size

Do you have up-to-date certification in any of the following?

Do you have previous background or training in working with children/teens who have been abused or neglected?*

YesNo

If yes, in what way?

Please describe why you wish to be a part Grace Chasers.*

Please describe how your experience can best help Grace Chasers meet its goals.*

Do you have any medical, emotional, or mental health conditions?*

NoYes

Please describe condition(s):

Have you taken drugs other than prescribed mediations?*

NoYes

If yes, please explain:

1) Have you ever been convicted of or pleaded guilty to any crimes (including crimes of record which have been expunged and pleas of 'no contest'), including municipal, state and federal?*

NoYes

2) Have you ever been placed on probation, received a Suspended Execution, Suspended Sentence or Suspended Imposition of Sentence for any offense involving a minor child (a child under 18), or been placed on ANY local, state, or federal sexual registry?*

NoYes

3) Have you ever been sued in a civil court of law where the allegations in the suit involved illegal, inappropriate, or sexual conduct or contact with a minor child?*

NoYes

4) Have you ever been subject to any court order involving any sexual, physical or verbal abuse including but not limited to any domestic violence or civil harassment injunction or protective order?*

NoYes

5) Have you ever resigned, been terminated or been asked to resign from a position, whether paid or as a volunteer, due to a complaint(s) of sexual, physical or verbal abuse of minors?*

NoYes

If yes to any of the above, please explain:*

High School Name*

Year of Graduation*

College

College Major

Year of Graduation

Other Education

Reference #1 - Name*

First NameLast Name

Reference #1 - Phone*

Area CodePhone Number

Reference #1 - Email*

Confirmation Email

Reference #2 - Name*

First NameLast Name

Reference #2 - Phone*

Area CodePhone Number

Reference #2 - Email*

Confirmation Email

Do you consider yourself to be a practicing Christian?*

NoYes

Please describe any current or previous experience working with children:*

List five (5) strengths you have in working with teens.*

How would you respond to a teen asking questions about his/her homosexual desires?*

How would you respond to a teen considering abortion?*

How would you respond to a teen dealing with deep depression or contemplating suicide?*

How well do you follow rules and respond to authority?

	1	2	3	4	5

1 is Poorly, 5 is Very Well

How well do you plan, organize and meet deadlines?

	1	2	3	4	5

1 is Poorly, 5 is Very Well

I would prefer the students I work with be:

Though our programs are open to all, without discrimination, Grace Chasers is a faith-based organization. With the vision and mission of Grace Chasers in mind, please express your statement of faith outlining your beliefs and what they're based upon.

REPRESENTATIONS AND RELEASE

I understand that Grace Chasers maintains strict policies against any form of child abuse, and that violation of these policies may be cause for dismissal. Child abuse is punishable by law, and Grace Chasers is bound by law to report allegations of abuse or any inappropriate sexual contact to the proper authorities. ALL reporting is kept confidential, by law. All volunteers must commit to immediately report any behavior that seems suspicious, questionable, abusive or inappropriate between: child-to-child, staff-to-child, and staff-to-staff.

If you are struggling with a sexual attraction to children, please opt out of service in Grace Chasers or any other child-serving organization, and seek help.

I understand that I will be required to submit to a background check as a condition of acceptance as a volunteer, and that unsatisfactory results, refusal to cooperate, or any attempt to affect the results of these background checks will result in me being removed as a volunteer or volunteer applicant.

I hereby certify that all of the information provided by me in this Application (or in any other accompanying or required documents) is correct, accurate and complete to the best of my knowledge. I understand that the falsification, misrepresentation or omission of any facts in these documents may (or will) be cause for the denial of acceptance as a volunteer, or immediate removal as a volunteer, regardless of the timing or circumstances of discovery.

I hereby authorize you to contact any references, churches, youth groups, schools attended, former and present employers, charities, courts, and any other person, agency, or organization that may have information about me, and for them to provide to you such information (including opinions) that they may have regarding my character and fitness for working with youth; I hereby release any such references, churches, youth groups, schools attended, former and present employers, charities, courts, and any other person, agency or organization who may have provided information about me, including record custodians, both collectively and individually, from any and all liability for damages of whatever kind or nature which may at any time result to me, my heirs, or family, on account of compliance or any attempts to comply with this authorization. I also agree to hold Grace Chasers harmless from any damages created by my unwarranted attempt to collect damages for providing information described above. I waive any right that I may have to inspect any information provided about me or by any person or organization identified by me in the Application process.

I understand that submission of an application does not guarantee my acceptance as a volunteer. I further understand that should Grace Chasers leadership extend an offer to me as a volunteer, it is for no specific duration and may be revoked at any time.

I understand that none of the documents, policies, procedures, actions, statements of Grace Chasers, its leadership or their representatives and agents used during the volunteer application process is deemed a contract, real or implied. If accepted as a volunteer, I agree to conform to the rules, regulations, policies, and procedures of Grace Chasers while serving as a volunteer, and understand that such compliance is a condition of remaining a volunteer.

I have carefully read the above Application and this Acknowledgement and Release, and know and understand its contents; I also know the above is a legally binding agreement. I sign this Application and Release of my own free will.

Please sign below:*

Grace Chasers Volunteer Application

Medical History

Criminal Background

Education

Personal References (No relatives)

Personal Profile

Thank you for your interest in being a Grace Chaser!