Volunteer Application and Background Check

Comprehensive application form capturing volunteer identity, availability, references, TB clearance status, and informed consent for background screening prior to placement.

Personal Information

• Legal First Name
• Legal Last Name
• Preferred Name (Optional)
• Date of Birth
  Required for background screening identity verification only. Not used for any other purpose.
• Email Address
• Primary Phone Number
• Mailing Address
• Do you have prior volunteer experience?

Volunteer Role and Availability

• Areas of Interest
  Select all that apply.
• If 'Other', please describe your area of interest
• Days Available
• Preferred Time of Day
• Estimated Hours Available Per Week
• Earliest Available Start Date
• Relevant Skills or Certifications
  Optional. List any skills, languages, or certifications relevant to your volunteer role.

Personal References

• Reference 1 — Full Name
• Reference 1 — Relationship to You
• Reference 1 — Phone Number
• Reference 1 — Email Address
• Reference 1 — How many years have you known this person?
• Reference 2 — Full Name
• Reference 2 — Relationship to You
• Reference 2 — Phone Number
• Reference 2 — Email Address
• Reference 2 — How many years have you known this person?

TB Clearance

• Current TB Clearance Status
• Date of Most Recent TB Test or Clearance
  Leave blank if not yet tested.
• Upload TB Clearance Documentation
  Upload a copy of your TB test result, IGRA result, or physician clearance letter. Accepted formats: PDF, JPG, PNG. Max 5 MB.
• Additional Notes Regarding TB Status (Optional)

Background Screening Consent

• I authorize the organization to conduct a background screening as described above
• Notice
  Consent to a background check is required for volunteer placement. If you do not consent, we are unable to process your application. Please contact us if you have questions.
• Have you ever been convicted of a felony or misdemeanor (excluding sealed or expunged records)?
  A prior conviction does not automatically disqualify you. Each case is reviewed individually.
• If yes, please briefly describe the nature and date of the conviction
  You are not required to disclose arrests that did not result in conviction, or records that have been sealed or expunged.
• Applicant Signature
  By signing, you certify that all information provided in this application is true and complete to the best of your knowledge, and that you consent to the background screening described above.
• Date of Signature