Application for Involvement

APPLICATION FOR INVOLVEMENT

Family Bridge Visitation and Community Services Center Providing monitored visitation, neutral exchanges, and related services for the community "Restoring Family Relationships and Building Stronger Communities"
Date

MonthDayYear
Date
PERSONAL INFORMATION
Full Legal Name:*

First NameLast Name
E-mail:*
Gender:*
Birthdate:
Main Contact#:*

Area CodePhone Number
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Emergency Contact*
Emergency Contact Number*
Emergency Contact Relationship To Applicant*
REQUIRED INFORMATION FROM ALL APPLICANTS
Have you ever been convicted of a felony? If so, please explain in detail.
Please list any local/national clubs, associations and or religious organizations that you are a member of.
Please list current and/or past volunteer experience.
Please list any skills, experience, or training you have received that will be helpful in a volunteer role with Family Bridge.
Do you have any special physical needs or restrictions that you would like us to be aware of?
Family Bridge Opportunities for Involvement
How did you hear about Family Bridge?
Please tell us why you are interested in volunteering with Family Bridge
If married, is your spouse/significant other/family aware of your interest in volunteering with Family Bridge? And do they fully approve/support your volunteerism?

YesNo
Volunteer Positions-please select the position(s) of interest.
Volunteer Positions*

Board MemberAdministrativeInternSocial MediaWebsiteEventsPublic Relations/MarketingOther
PROFESSIONAL REFERENCE
Full Legal Name:*

First NameLast Name
Company/Organization:*
Email:*
Main Contact#:*

Area CodePhone Number
Relationship to applicant:*
How many years have you worked with this person and in what capacity have you worked with them?*
Does this person know that we will be contacting them? *

YesNo
GENERAL REFERENCES

We suggest one immediate family member and one close friend
REFERENCE #1
Full Legal Name:*

First NameLast Name
Email:*
Main Contact#:*

Area CodePhone Number
Relationship to applicant:*
How many years have you worked with this/known person and in what capacity ?*
Does this person know that we will be contacting them? *

YesNo
REFERENCE #2
Full Legal Name:*

First NameLast Name
Email:*
Main Contact#:*

Area CodePhone Number
Relationship to applicant:*
How many years have you worked with/known this person and in what capacity?*
Does this person know that we will be contacting them?*

YesNo
In consideration of Family Bridge Visitation and Community Services Center, Inc., based in Georgia, a non-profit corporation, organizing, arranging and permitting me to attend and participate in any event, I hereby waive all rights which I may have or which may accrue in the future against Family Bridge and/or any Family Bridge representative from and agree to indemnify and hold Family Bridge and their representatives harmless from and against all liability from and all actions, damages, causes of action, suits, costs, losses, expenses, claims, demand, damages and judgments (collectively the "Losses and Claims"), which I, my spouse, family members, children, heirs, executors, administrators, successors and assignees ever had, now have or hereafter can, shall or may have resulting from or arising in connection with my travel to attendance, at or participation in Family Bridge events.
I have read above statements and accept full responsibility:*

I ACCEPTI DO NOT ACCEPT
Type full legal for your signature:*
Should be Empty:

APPLICATION FOR INVOLVEMENT

PERSONAL INFORMATION

REQUIRED INFORMATION FROM ALL APPLICANTS

Family Bridge Opportunities for Involvement

Volunteer Positions-please select the position(s) of interest.

PROFESSIONAL REFERENCE

GENERAL REFERENCES