Showell Foundation: Volunteer Opportunities

Showell Foundation Volunteer Form, 2008
Name
Address
City
State
Zip
Home Phone
Business Phone
E-mail Address
Date of Birth
Occupation
Employer
Address
Special professional training, skills, hobbies
Community affiliations (Clubs, Service Organizations, etc.)
Previous volunteer experience
Special Certification (i.e. CPR, Medical, etc.)
Do you have a valid driver’s license
Driver's License #
State
Have you ever been convicted of or plead guilty to any crime(s)
If yes, describe each in full
Have you ever been refused participation in any other youth programs?
If yes, describe each in full
In which of the following would you like to participate?
Please list three references, at least one of which has knowledge of your participation as a volunteer in a youth program. Include Name and Phone Number.

A copy of a valid government issued photo identification must be presented before being appointed as a volunteer for the Showell Foundation.

As a condition of volunteering, I give permission for the Showell Foundation, Inc. to conduct a background check on me, which may include a review of sex offender registries, and child abuse and criminal history records. I understand that, if appointed, my position is conditional upon the Foundation receiving no inappropriate information on my background. I hereby release and agree to hold harmless from liability the Showell Foundation, Incorporated, the officers, employees and volunteers thereof, or any other person or organization that may provide such nformation. If appointed, I understand that if I violate the Showell Foundation policies and/or procedures, the President and Board of Directors may suspend my appointment.

Applicant Name _______________________________________Date __________

NOTE: the Showell Foundation, Inc. will not discriminate against any person on the basis of race, creed, color, national origin, marital status, gender, sexual orientation or disability.

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