KWF Risk Management Volunteer Application
Please complete this application in order to work with our Youth Initiative Programs (Delta Academy, GEMS, EMBODI, and Jabberwock)
Name (First and Last) *
Your answer
1. Are you at least 18 years of age *
2. Are you willing to attend a training course about Delta's policies and procedures governing its youth initiatives and to keep current on updated policies? *
3. Do you agree to complete a background screening? *
4. Have you ever been charged with, or convicted of any crime, including any misdemeanor or felony? *
If “Yes”, provide details below. For each instance, provide the following information: (a) the relevant charges; (b) relevant dates; (c) identify the court(s) in which any proceedings were held; (d) supply the disposition related to all charges (e.g., acquittal; conviction; no contest; charges currently pending, etc.); and (e) list the punishment that was issued related to any convictions.
Your answer
5. Have you ever been investigated by state or federal authorities for child abuse or neglect? *
If "yes", provide details below, including (a) reason for investigation; (b) relevant dates; (c) relationship to child/children involved; (d) the agency or agencies that conducted the investigation; (e) the court(s) in which any proceedings were held; (f) results of investigation; (g) any punishment or other requirements imposed by the relevant authorities.
Your answer
6. Have you ever been treated (outpatient or inpatient treatment) for any mental illness, psychiatric condition, or drug or alcohol addiction? *
If yes, explain below, and provide applicable dates of treatment or hospitalization.
Your answer
7. Have you ever been terminated from a paid or volunteer position? *
If yes, explain below.
Your answer
8. Other than the above, is there any fact or circumstance involving you or your background that would call into question your being entrusted with the supervision, guidance or care of young people? *
Provide additional explanations below and reference the applicable question number.
Your answer
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