Volunteer

volunteer opportunity Form

CONTACT INFORMATION: ALL INFORMATION IS REQUIRED FOR BACKGROUND CHECK

Submit a volunteer opportunity here:

Name (Last, First, Middle)

Date of Birth (including year)

Social Security #

Street Address (not PO box)

City

US State

Postal Code

Primary Phone Number

E-mail

Have you ever volunteered or worked with a Boys & Girls Club previously?

Yes

No

If you answered yes, please list : Name and location of Club, Contact Person, and Phone Number. If you answered no, please skip this section.

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REFERENCES

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Please provide the following information for three people who have known you for two years or more and whom we may contact. (DO NOT include relatives)

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Reference 1:

First Name

Last Name

Address Line 1

City

US State

Postal Code

Phone Number

Email

Relationship

Years Known

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Reference 2:

Prefix

First Name

Last Name

Country

Address Line 1

City

US State

Postal Code

Phone Number

Email

Relationship

Years Known

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Reference 3:

First Name

Last Name

Address Line 1

City

US State

Postal Code

Phone Number

Email

Relationship

Years Known

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AVAILABILITY: PLEASE FILL IN HOURS OF AVAILABILITY

New Field:

Which club location would you prefer to volunteer?

Areas in which you are interested to volunteer

Early Childhood Program

Afterschool Programs

Athletics

Events

Are you over the age of 18?

Yes

No

Have you been convicted of a crime in the last 10 years?

Yes

No

If you answered yes, please list and explain all convictions. Include date of conviction, city & state, and what the conviction was. This will not automatically bar you from volunteer activities:

How did you hear about this volunteer opportunity?

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Note: Due to the nature of the work involved with the Boys & Girls Clubs of the Greater Santiam, all prospective employees and volunteers will be subject to a criminal history check. This check is confidential and open to explanations. By signing on the line below you are both authorizing this background check and confirming that all information listed is valid and truthful to the best of your knowledge. By Signing below, I hereby consent to a background check annually for the duration of my involvement as a volunteer with the Boys & Girls Clubs of the Greater Santiam.

First Name

Last Name

Month

Day

Year

Share Your Time & Talents

Make a Lasting Impact

Interest in Volunteering?

volunteer opportunity Form

CONTACT INFORMATION: ALL INFORMATION IS REQUIRED FOR BACKGROUND CHECK

Submit a volunteer opportunity here:

Get Involved or Reach Out

Together, We Build Great Futures.

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