Volunteer Facilitator Training Application

Dear Applicant,

Thank you for your interest in Common Ground Grief Center’s Volunteer Facilitator Training. Our volunteers are the heart of our program and contribute their time and energy into helping make a difference in the lives of grieving children, teens, and their families. Our Volunteer Training is 4 days and all 4 days must be completed to become a facilitator. The cost of our training is $95.00 which covers the cost of food, handouts and other items. We require a $35.00 non-refundable deposit which you will pay upon completion of this application. Please carefully review and complete the information in this application. Additionally, please read and complete the application regarding “Criminal Background Check.” 

Sincerely,

Lynn M. Snyder LPC, ATR-BC, FT Executive Director/Founder

Request For Personal References

Please list the names, addresses, and phone numbers of three references:

I understand that I am required to attend all 21 hours (4 sessions) of the volunteer facilitator training before I can become a facilitator in a peer support group at Common Ground. I understand that Common Ground reserves the right to accept or reject any potential trainee as a facilitator even after they have completed the sessions.

I understand that training is offered only to those that intend to volunteer for at least one year as a facilitator of a peer support group at Common Ground, and that this commitment is 3 1/2 hours every other week. I understand that in order to be considered/accepted as a facilitator, Common Ground will complete a criminal background check on me. I understand that the cost for the training is $95.00 and that a $35.00 non-refundable deposit is required and submitted with this application. I will pay the remainding $60.00 on the first day of the training.

I have completed this form to the best of my knowledge and will complete the background check form and submit my deposit.

Criminal Background Check

 

DISCLOSURE AND AUTHORIZATION FORM 

DISCLOSURE REGARDING BACKGROUND INVESTIGATION Common Ground Grief Center(the “Company”) will procure a consumer report and/or investigative consumer report on you in connection with your volunteer or employment application. Coeus Global LLC, or another consumer reporting agency, will obtain the report for the Company. Coeus Global LLC is located at PO Box 885 Cottonwood, CA 96022 and can be reached at 866-765-0592. The report will contain information bearing on your character, general reputation, personal characteristics, mode of living and credit standing. The types of information that may be obtained include but are not limited to: credit reports, social security number verification, criminal records checks, public court records checks, driving records checks, educational records checks, verification of employment positions held, personal and professional references checks, licensing and certification checks, etc. The information contained in the report will be obtained from private and/or public record sources, including sources identified by you or through interviews or correspondence with your past or present coworkers, neighbors, friends, associates, current or former employers, educational institutions or other acquaintances. The nature and scope of any investigative consumer reports that may be requested is explained above. You are nonetheless entitled to request more information about the nature and scope of such reports by submitting a written request to: Coeus Global LLC Compliance Department, P.O. Box 885 Cottonwood, CA. 96022 or faxed to 530-341-0036. The Company is furnishing you with a summary of your rights under the Fair Credit Reporting Act in a form prescribed by the Federal Trade Commission along with required state law notices in states where applicable.

 

 AUTHORIZATION REGARDING BACKGROUND INVESTIGATION

I have carefully read and understand this Disclosure and Authorization form. By my signature below, I consent to the release of consumer reports and investigative consumer reports prepared by a consumer reporting agency, such as Coeus Global LLC to Common Ground Grief Center (“the Company”). I understand that if the Company approves me as a volunteer or employee, my consent will apply throughout my service unless I revoke or cancel it by sending a signed letter to: Compliance Department, P.O. Box 885 Cottonwood, CA. 96022 or faxed to 530-341-0036. I understand that, to the extent allowed by law, information contained in my volunteer application or otherwise disclosed by me before, during or after my service as a volunteer, if any, may be utilized for the purpose of obtaining consumer reports or investigative consumer reports. By my signature below, I also authorize the disclosure of information concerning my employment history, earnings history, education, credit history, credit capacity and credit standing, motor vehicle history and standing, criminal history, and all other information deemed pertinent by the consumer reporting agency to the agency by the following: past or present employers; learning institutions, including colleges and universities; law enforcement agencies; federal, state and local courts; the military; credit bureaus; and, motor vehicle records agencies.

You may obtain information or copies from the Company's investigative report file at any time by contacting: Coeus Global Compliance Department, P.O. Box 885 Cottonwood, CA. 96022 or by toll free call at 866-765-0592.

 

 

BACKGROUND CHECKS ARE REQUIRED FOR ALL NEW VOLUNTEERS. ONCE YOU SUBMIT YOUR DEPOSIT YOU WILL BE REDIRECTED TO THE BACKGROUND CHECK WEBSITE.