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Run: Volunteer Application and Background Check

Volunteer application and background check form for collecting applicant details, role fit, availability, references, TB clearance, and screening consent bef...

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Personal Information

Legal First Name (required)

Legal Last Name (required)

Preferred Name (if different)

Date of Birth (required)

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 (required)

Primary contact for application updates and scheduling.

Phone Number (required)

Mailing Address (required)

Used for mailing any required documentation.

Government-Issued ID Type (required)

Select the type of ID you will present at orientation for identity verification.

Volunteer Role and Availability

Areas of Interest (required)

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 (required)

Preferred Time of Day (required)

Hours Available Per Week (required)

Earliest Available Start Date (required)

Describe any prior volunteer or relevant work experience

Personal References

Reference 1 – Full Name (required)

Reference 1 – Relationship to You (required)

Reference 1 – Phone Number (required)

Reference 1 – Email Address

Reference 2 – Full Name (required)

Reference 2 – Relationship to You (required)

Reference 2 – Phone Number (required)

Reference 2 – Email Address

TB Clearance

TB Clearance Status (required)

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. (required)

You must authorize the background check to proceed with your application.

Yes No N/A

I authorize the organization to contact the references I have provided to verify my suitability for a volunteer role. (required)

Yes No N/A

I understand that my application and screening records will be retained for a minimum of 3 years in accordance with organizational record-retention policy. (required)

Yes No N/A

Applicant Signature (required)

By signing, you certify that all information provided in this application is true and complete to the best of your knowledge.

Date Signed (required)

Get your results

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Email (required)

Your name (optional)

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