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Volunteer application form

Before serving, we will also need a completed background check.
Please complete this application form if you are interested in becoming a volunteer with UP for Women and Children.
Once you have completed the form, click the submit button at the bottom.
Email address *
Name *
First and last name
Your answer
Address *
Street
Your answer
Address *
City, State, Zip
Your answer
Email *
Your answer
Phone number *
Your answer
Date of Birth *
MM
/
DD
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YYYY
What skills can you contribute? *
Your answer
What experience do you have in this area?
Your answer
What days will you be available? *
Required
How many hours are you willing to volunteer? *
Required
Highest Level of Education? *
Current Employer? *
Your answer
Job Title? *
Your answer
Personal Reference Name: *
Your answer
Personal Reference Phone: *
Your answer
Emergency Contact Name: *
Your answer
Emergency Contact Relation to Contact: *
Your answer
Emergency Contact Phone: *
Your answer
Why are you interested in volunteering with UP? *
Your answer
Please list any previous involvement, service, skills or training pertinent to this population.
Your answer
What may be challenging for you in working with this population? *
Your answer
What would make volunteering difficult for you? *
Your answer
Do you have any certifications such as First Aid or CPR?
If yes, what are the certifications and expiration dates?
Your answer
To ensure the safety of our participants, our organization requires background checks on all volunteers. Due to the population we serve, we are unable to allow individuals who have ever been convicted of physical or sexual abuse of a minor or adult. Have you ever been involved in a family court case due to allegations of child abuse or neglect? *
If so, please explain?
Your answer
Have you ever been convicted of a felony or misdemeanor (other than minor traffic violations)? *
As a new organization, our funds are minimal. Would you be willing to pay for your own $11 background check? *
Please share how you heard about UP. *
Your answer
Please read, initial and date each statement below.
I verify that the information contained in this application is true and correct to the best of my knowledge. I give my permission, if necessary, for you to contact any references provided. I waive any right to inspect any information provided about me by any person or organization identified by me in this application. *
Your answer
I acknowledge that UP reserves the right to reject my application for any reason including, but not limited to, lifestyle choices that are not consistent with the Doctrinal Details or Code of Conduct of UP. *
Your answer
In consideration of the receipt and evaluation of this application by UP, I hereby release any individual, church, organization, employer, reference or any other person from any and all liability for damages which may at any time result to me, my heirs, or family, on account of compliance or any attempts to comply with this organization. *
Your answer
We like to keep volunteers informed of important news, schedules, and volunteer opportunities by email, however we will not send you any emails you prefer not to receive. Use the check boxes below to select the kinds of email you would like to receive from us. *
Required
I understand and agree that submitting this application form does not automatically register me as an UP for Women and Children volunteer, and that there may be certain qualifications I must meet, including the acceptance of established volunteer policies and procedures before I may begin volunteering. *
Required
By submitting this form, I attest that the information I have provided on the form is true and accurate. *
Required
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