Volunteer/Employment Application

Volunteer/Employment Application

Thank you for your interest in serving with Coda Mountain Academy! This is an application for both volunteers and those seeking employment with Coda. The information on this application will remain confidential, in keeping with the legal requirements of the organization.
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

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

Area CodePhone Number
Are you 18 years or older?*

YesNo
Education (Select the highest level of education completed.)*

High SchoolSome CollegeBA/BS DegreeMaster's DegreeOther
Are you applying to be a volunteer or an employee?*

VolunteerEmployeeOther
Why do you want to volunteer or work for Coda? What do you want to gain from your experience?*
Our after school programs run Monday-Thursdays between 2-5:30 PM depending on the school. Please select all days that you would be available to work.*

MondayTuesdayWednesdayThursday
If interested in children/youth positions, which age group do you prefer to work with?*
This is not a guarantee that you will work only with this age group.
What skills, interests or strengths do you feel you would bring to Coda as a volunteer/employee?*

Musical Instrument SkillsExperience with Lego RoboticsExperience Leading Arts & CraftsKitchen/Cooking SkillsCleaning SkillsSpreadsheet SkillsWriting SkillsWilling to Run Errands or Transport Instruments, etc.Other
If you have musical instrument skills, which instruments would you be able to teach?
Please list your previous/current volunteer work and/or job positions:*
Trainings received (leadership, child abuse training, child protective and other training):*
Do you have any health or physical limitations that could affect your volunteer/work assignments?*

YesNo
If yes, please explain.
Have you ever been discharged from a job or forced or asked to resign?*

YesNo
If yes, please explain.
Are there any circumstances or pattern in your life which would make it, inappropriate for you to serve with children or youth, or would compromise the integrity of Coda?*

YesNo
If yes, please explain.
Have you had possession, use, or sale of illegal or legal drugs and/or have abused alcohol within the last 7 years?*

YesNo
If yes, please explain
Have you ever been charged/convicted of or plead guilty/no contest to:*

MisdemeanorFelonyChild Abuse, Neglect, or MolestationSexually related offenseDrug possession, use, or saleNo, none of the above
If yes, please explain.
*Other than citations/convictions expunged, sealed, set aside by law, or otherwise protected by applicable law from disclosure on this employment application. A conviction includes a guilty verdict, guilty finding, guilty plea, or “no contest” plea, whether or not a sentence was imposed.
If your response to any of the seven preceding questions was “Yes”, give the date, place and nature of each such conviction(s) or pending charge. (The existence of a conviction or pending charge will not necessarily preclude you from volunteering or working with Coda; the nature of the crime and its relationship to the volunteer/work position, the degree of rehabilitation that has occurred and the time elapsed since the crime or release from confinement will be considered.)
Although Coda is legally a neutral organization, there are many people of faith working the program. Are you comfortable with this?*

YesNoOther
How did you hear about us?*

FriendCommunity EventNewspaperSocial MediaOther
References

Please provide the following information for at least two people who are over 18 years of age and able to provide a reference supporting your character and your integrity in relation to working with children or youth. If possible, one reference should be a pastor, teacher, or employer.
Reference 1
Name*

First NameLast Name
Email*
example@example.com
Relationship*
Phone Number*

Area CodePhone Number
Reference 2
Name*

First NameLast Name
Email*
example@example.com
Relationship*
Phone Number*

Area CodePhone Number
Reference 3
Name

First NameLast Name
Email
example@example.com
Relationship
Phone Number

Area CodePhone Number
Any questions or comments?
Should be Empty:

Volunteer/Employment Application

References