Voices for Children Advocacy Center Volunteer Application
Voices for Children has the right to reject any applicant found to have been convicted of or having charges pending for, a felony or misdemeanor involving a sex offense, child abuse or neglect, or related acts that would pose risks to children. *
By initialing below, you understand the above statement
First Name *
Middle Name
Last Name *
Maiden name or alias
What is your date of birth? *
MM
/
DD
/
YYYY
Ethnic Background (Completion Optional)
The following information is used to determine diversity of Voices for Children Volunteer
What is your gender? *
Address *
City *
State *
Zip Code *
Telephone *
Email Address *
Please list your areas of interest *
Required
List current and prior volunteer experiences
Education
Highest level of education, if applicable list your degree.
Highest Level of Education
Field of Study
Employment
Past Employment, position, dates (last 5 years)
Emergency Contact (First and Last Name, Home Address, Telephone, Email)
References
Due to the sensitive nature of our work, we request three professional, non-relative references.
Reference 1 *
Include Phone and E-mail
Reference 2 *
Include Phone and E-mail
Reference 3 *
Include Phone and E-mail
Questionnaire
How did you learn about volunteer opportunitites at Voices for Children Advocacy Center?
Do you have any physical limitations? *
If yes, select other
Required
Have you ever been convicted of a crime? *
If yes, please select other and list offense, date and disposition
Required
Have you ever had any felony or misdemeanor charges pending against you? *
If yes, please explain by selecting other
Required
Have you ever had a personal protection order (PPO) against you? *
If yes, please explain by selecting other
Required
Have you ever been involved in the abuse or neglect of a child or adult? *
If yes, please explain by selecting other
Required
Have you ever been involved with a protective service agency? *
If yes, please explain by selecting other
Required
Have you lived in Michigan for the past 5 years? *
If no, please list the state and years of residence by selecting other
Required
Are you willing to sign a release of information of any and all criminal records, any and all CPS history, and sign a confidentiality disclosure? *
Required
By initialing here, you agree to notify Voices for Children of any pending felony or misdemeanor charges within 10 days after first date of service. *
Please type your initials here.
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