Volunteer Application

Name *

First Name

Last Name

Phone *

(###)

###

####

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Date of birth *

MM

DD

YYYY

Are you a United States Citizen? *

Yes

No

Gender *

Male

Female

Today's date *

MM

DD

YYYY

REFERENCE 1 *

All references should be from non-family sources.

First Name

Last Name

REFERENCE 2 *

First Name

Last Name

REFERENCE 3 *

First Name

Last Name

Service hours, community service, and/or educational credits *

Would your volunteer experience with us be used to fulfill any volunteer, community service, or educational requirements? Please note any requests for approval or documentation of any such hours must be approved in advance of volunteer service.

Yes

No

Have you had any license, certificate, student status, or employment suspended, revoked, terminated, or otherwise adversely affected? *

Yes

No

Have you ever been convicted of a felony or misdemeanor? *

Yes

No

Are there any criminal charges currently pending against you? *

Yes

No

Has your name ever appeared on a sex offender registry? *

Yes

No

Have you ever been convicted, plead guilty, plead no contest, or had adjudication withheld on any crime except minor traffic offenses? *

Yes

No

Confirmation *

I certify that all the information on this application, my resume, or any supporting documents or attachments is correct, and I understand that any willful representation or omission of any information may result in disqualification from consideration for volunteer employment, or, if employed, my termination. I hereby authorize Soul Spin and/or its agents to investigate all statements contained in this application, resume, and/or supporting documents. This information may include, but not be limited to, information pertaining to any charges or convictions I may have for federal and/or state criminal violations, including allegations and convictions for crimes committed upon minors, and will be gathered from any law enforcement agency of any state or federal governments, or other source, to the extent permitted by state and federal laws. I hereby authorize Soul Spin and/or its agents to make an independent investigation of my background, references, character, past employment, education, criminal or police records, including those maintained by both public and private organizations and all public records for the purpose of confirming the information contained on my application and or obtaining other information which may be material to my qualifications for volunteer employment now and, if applicable, during the tenure of my volunteer employment with Soul Spin. I hereby authorize all persons, public agencies, courts, schools, employer companies or corporations, to supply Soul Spin and/or its agents verification of the information provided in my application, including, without limitations, evaluations of my prior performances, and I release them from all liabilities, claims, or law suits from their doing so. I understand that any and all information collected by Soul Spin and/or its agents may be used by Soul Spin for the purpose of evaluating me for volunteer employment, reassignment, retention as a volunteer employee, or other volunteer employment purposes (including contract for services). I understand that this application is not a contract, offer, or promise of volunteer employment. An offer of volunteer employment will be contingent upon successful verification of information contained in this application. If hired, I will be able to resign at any time for any reason. Likewise, Soul Spin can terminate my volunteer employment at any time, with or without reason.

I Agree

I Disagree