TJ Robisnon Life Center
VOLUNTEER APPLICATION
Legal Name
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Date of Birth
*
-
Month
-
Day
Year
Date Picker Icon
Cell Phone Carrier
*
Best Time to Call
*
Social Security Number
*
E-mail
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Service You Would Like to Volunteer:
Tournament Volunteer
Program/Class
Other
How Often Would You Like To Volunteer
Every Week
Once a Month
Twice a Month
List Any Leadership/Volunteer Experience You Have Had:
List any training, education or talents that have shaped you to serve our community
Have You Ever Been Accused, Charged With, or Alleged to Have Committed Any Act of Neglect, Abuse, or Molestation Against A Minor? If Yes, Explain in Detail, Providing Date and Place of Incident:
Local Personal References (Must Be 18 Years Old and Not Related to You)
Reference Name
First Name
Last Name
Phone Number
-
Area Code
Phone Number
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Reference Name
First Name
Last Name
Phone Number
-
Area Code
Phone Number
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
I hereby authorize TJ Robinson Life center to verify all information contained in this application with any references, my past or present employers, any other appropriate personnel at my past or present employment, churches or other organizations, and any individuals. I authorize those who are contacted to disclose any and all information to TJ Robinson Life Center. I authorize a background and sex offender search to be conducted in order for me to participate with the TJ Robinson Life Center. I release all such persons or entities from liability that may result or arise from TJ Robinson Life Center’s collections of all such evaluations or information for its consideration of my application. Should my application be accepted, I agree to follow the policies of TJ Robinson Life Center and to refrain from unscriptural conduct in the performance of my services on behalf of the center. I understand that this personal information will be held confidential by the center staff.
I agree with the statement above
I am the parent/legal guardian of the applicant and I agree with the statement above
Signature
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