Volunteer Application Form
For Persons Volunteering to Work With Children and Youth Intermittently: Reference Check
Please Print Clearly and Complete the Entire Document. Once completed, return to the School Office. This form must be completed before you have contact with children.

All information will remain confidential except as set forth herein.

Name
Your answer
Home Phone
Your answer
Address
Your answer
Work Phone
Your answer
City
Your answer
Zip
Your answer
Social Security No.
Your answer
Date of Birth
MM
/
DD
/
YYYY
Mailing Address if different from above
Your answer
List other names you use or are known by
Your answer
Volunteer activity you wish to perform
Your answer
Hours available
Your answer
Days of the week available
Present Occupation
Your answer
Employer/Business Name
Your answer
Employer/Business Address
Your answer
Education Completed
Your answer
Certificates/Special Training
Your answer
Previous experience working with children/youth in organizations, schools, parishes professionally (Please list activity and name of organization, school, parish)
Professional Experience
Your answer
Previous experience working with children/youth in organizations, schools, parishes as a volunteer (Please list activity and name of organization, school, parish)
Volunteer Experience
Your answer
Please list two references. Your references should be people that know your work and personal character
Name
Your answer
Mailing Address
Your answer
Phone
Your answer
Name
Your answer
Mailing Address
Your answer
Phone
Your answer
Are you addicted to alcohol, drugs, or any illegal substance? *
Have you been convicted of a crime, other than a minor traffic violation? *
Have you ever been convicted of child neglect, abuse, or sexual misconduct?
Have you ever been suspended, dismissed, or asked to resign a paid position or volunteer position involving children?
If you answered "yes" to any of the above questions, please explain
Your answer
I would agree to undergo finger-printing if this was considered necessary
I understand that the information that I have provided may be verified and used to evaluate my suitability for volunteer work, by contacting the persons, parishes or organizations named in this application, as well as any agency (e.g. Department of Justice Child Molester Registry Program) authorized by law to provide criminal records or information to the Archdioceses. I hereby release and agree to hold harmless from the school, parish, the Roman Catholic Archbishop of San Francisco, the Roman Catholic Welfare Corporation, the Archdiocese of San Francisco, and the officers, directors, employees, and volunteers thereof. I affirm the foregoing is true and correct to the best of my knowledge.
By checking here you agree that all the above is true *
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