Allen Neighborhood Center: Community Service Form
Thank you for your interest in volunteering with the Allen Neighborhood Center! Complete the following form to be considered for volunteerism. After its submission and review, the Volunteer Coordinator, Pa Vang, will contact you to schedule a volunteer orientation.
Today's Date
MM
/
DD
/
YYYY
First Name *
Your answer
Last Name *
Your answer
Gender *
Your answer
Birthdate *
MM
/
DD
/
YYYY
Email Address *
Your answer
Address *
Your answer
City, State, Zip *
Your answer
Phone Number *
Your answer
Secondary Phone Number
Your answer
Emergency Contact and Phone Number
Your answer
Please list any hobbies, talents, skills, etc.
Your answer
Court Appointed Contact
List the name and phone number of your assigned court appointed contact. Court paperwork concerning your court assignment, deadlines, and other requirements or related information must be submitted to volunteer@allenneighborhoodcenter.org to be considered for volunteerism.
Name of Court *
Your answer
Contact Person *
Your answer
Address *
Your answer
City, State, Zip *
Your answer
Phone Number *
Your answer
Email *
Your answer
How many hours must you serve?
Your answer
When do you need to complete your hours? *
MM
/
DD
/
YYYY
Program Interests
Below is a list of possible volunteer opportunities with the Allen Neighborhood Center. To learn more about these programs, please see our website at allenneighborhoodcenter.org.
Please check any and all that you think may interest you:
How did you hear about us? *
Required
Would you like to subscribe to our volunteer email list?
How would you like to be contacted? *
Background Check Consent Form
On April 28th, 2008 the ANC Board of Directors approved the following procedures for screening all those who are applying to volunteer with Allen Neighborhood Center.

1. All Volunteer and staff (with the exception of Michigan State University students, who are screened by MSU Service Learning Center) will be screened through the Michigan State Police I-Chat System.

2. Confidential files are kept on all applicants and results.

3. When the I-Chat System reveals a criminal background, the Volunteer Program Coordinator, in consultation with the Executive Director, will make a determination whether this person's offer of volunteer service will be accepted.

I understand and accept the terms listed above for participation as a volunteer at the Allen Neighborhood Center. By submitting my electronic signature, I verify this represents my actual signature and hereby gives my consent to Allen Neighborhood Center to conduct a criminal background check using the information I have provided.

Full Legal Name *
Your answer
Race/Ethnicity (This is helpful for background checks)
Your answer
Electronic Signature *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Submit
Never submit passwords through Google Forms.
This form was created inside of Allen Neighborhood Center. Report Abuse - Terms of Service - Additional Terms