SCYM Volunteer Application 2018-19
By filing out and signing this form, you attest that all answers are true to the best of your knowledge.
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With which program are you interest in volunteering?
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Address: (Street, City, State, Zip Code)
Phone Number & Alternate Phone Number:
Emergency Contact and Phone Number:
Best way to contact you:
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Do you have any medical conditions we should be aware of in case of emergency? (asthma, epilepsy, diabetes, serious allergies, etc.)
For insurance purposes, IF UNDER 25, what is your age?
To your knowledge, have you had a background check run by anyone (school, church, employer) in the last 5 years?
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If so, who performed the background check and who's the contact person at that agency?
List 2 character references, their addresses and phone numbers:
All volunteers who have not been background checked in the last 5 years may be required to undergo a background check in order to work with children and youth at SCYM. Thank you for your understanding as we work to protect the safety of our children. Please sign here:
Are you under the age if 18?
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