Volunteer Application and Background Check

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

Personal Information

• Legal First Name
• Legal Last Name
• Preferred Name (if different)
• Date of Birth
  Required for identity verification and background screening. Must be 18 or older to apply independently; ages 14–17 require a signed parental consent form.
• Email Address
  Primary contact for application updates and scheduling.
• Phone Number
• Mailing Address
  Used for mailing any required documentation.
• Government-Issued ID Type
  Select the type of ID you will present at orientation for identity verification.

Volunteer Role and Availability

• Areas of Interest
  Select all that apply.
• Please describe your other area of interest
• Relevant Skills or Certifications
  List any skills, licenses, or certifications relevant to your volunteer role.
• Days Available
• Preferred Time of Day
• Hours Available Per Week
• Earliest Available Start Date
• Describe any prior volunteer or relevant work experience

Personal References

• Reference 1 – Full Name
• Reference 1 – Relationship to You
• Reference 1 – Phone Number
• Reference 1 – Email Address
• Reference 2 – Full Name
• Reference 2 – Relationship to You
• Reference 2 – Phone Number
• Reference 2 – Email Address

TB Clearance

• TB Clearance Status
• Date of Most Recent TB Test or Clearance
  Required if you selected 'I have a current TB clearance' above.
• Upload TB Clearance Documentation
  Upload a copy of your TB test results or clearance letter (PDF, JPG, or PNG; max 5 MB).
• Scheduled TB Test Date
  Please provide your scheduled test date so we can follow up.

Background Screening Consent

• Background Check Disclosure
  A consumer report (background check) may be obtained for volunteer placement purposes. The report may include criminal history, sex offender registry status, and identity verification. You have the right to request a copy of the report and to dispute inaccurate information. Adverse action will not be taken solely on the basis of a criminal record without an individualized assessment. This disclosure is made pursuant to the FCRA and applicable state law.
• Screening Components That May Apply to Your Role
  The coordinator will confirm which components apply based on your assigned role.
• I authorize the organization to obtain a consumer report (background check) for volunteer placement purposes, as described in the disclosure above.
  You must authorize the background check to proceed with your application.
• I authorize the organization to contact the references I have provided to verify my suitability for a volunteer role.
• I understand that my application and screening records will be retained for a minimum of 3 years in accordance with organizational record-retention policy.
• Applicant Signature
  By signing, you certify that all information provided in this application is true and complete to the best of your knowledge.
• Date Signed