VOLUNTEER APPLICATION

VOLUNTEER APPLICATION
Upload or take a photo. Picture should be in-front of a solid color background, from from head to waist only. This photo will be used for your required City of Burlington Volunteer ID Badge.
Name*

First NameLast Name
Are you over 18?*

YesNo
D.O.B

MonthDayYear
Date
Email*
example@example.com
Current Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
Please check all activities that you are interested in volunteering with:

BasketballBaseballCheerDanceFootballSoftballSoccerTrackT-BallWrestlingOther
Please note that all volunteers must complete a background check and successfully pass a background in order to volunteer. Upon successful completion, you will be issued a City of Burlington Volunteer Id badge. In addition, you must complete an online concussion training and a three-hour Rutgers' Safety Clinic.

NEW- Every volunteer must complete Protecting Children Training. Course information will be emailed to the email on record.

To schedule, your fingerprint background check will schedule at http://uenroll.identogo.com/

2F1J3Y - NJ920610Z NJSP VOLUNTEER REVIEW OPS YOUTH SERVING ORGANIZATION VOLUNTEER YSB

SERVICE CODE 2F1J3Y

Contributor’s Case# C09003

Fingerprints must be completed every three years. To be reimbursed for the fee you must submit the receipt to the Recreation Department.
Have you completed the Rutgers' Safety Clinic?

YesNoUnsure
CONCUSSION CERTIFICATION

Please use the following link to complete the annual concussion training. Please email your certificate of completion to jcmartin@burlingtonnj.us

https://nfhslearn.com/courses/61064/concussion-in-sports
Electronic Signatures
By using the Site and providing Submissions, you agree to transact electronically through the Site. You agree that your electronic signature is the legal equivalent of your manual signature. You further agree that your use of a key pad, mouse or other device to select an item, button, icon or similar act/action, constitutes your signature as if actually signed by you in writing. You also agree that no certification authority or other third-party verification is necessary to validate your electronic signature, and the lack of such certification or third party verification will not in any way affect the enforceability of your electronic signature.
First Name* Last Name* Date*
Electronic Signature Date
Email Confirmation*
example@example.com
Should be Empty: