Volunteer Form

* Indicates required field

Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Email *

Social Security # *

Date of Birth *

Phone Number *

Occupation *

Employer *

Work Number *

Special professional training, skills, hobbies *

Community affiliations (Clubs, Service Organizations, etc.) *

Previous volunteer experience *

Do you have children in any SLC programs? *

Yes No

Special Certification (CPR, Medial, etc.) *

Do you have a valid driver's license *

Yes No

Are there any criminal charges pending against you regarding any crime(s) involving or against a minor? *

Yes No

If yes, describe each in full *

Please list three references, at least one of which has knowledge of your participation as a volunteer in a youth program (Name & Number Only) *

AS A CONDITION OF VOLUNTEERING, I give permission for the Skillful Living Center, Inc. to conduct background check(s) on me now and as long as I continue to be active with the organization, which may include a review of sex offender registries (some of which contain name only searches which may result in a report being generated that may or may not be me), child abuse and criminal history records. I understand that, if appointed, my position is conditional upon the league receiving no inappropriate information on my background. I hereby release and agree to hold harmless from liability the Skillful Living Center, Inc., the officers, employees and volunteers thereof, or any other person or organization that may provide such information. I also understand that, regardless of previous appointments, Skillful Living Center, Inc. is not obligated to appoint me to a volunteer position. If appointed, I understand that, prior to the expiration of my term, I am subject to suspension by the President and removal by the Board of Directors for violation of Skillful Living Center, Inc. policies or principles.

Please agree to the terms above *

Yes, I agree

Applicant Name *

Parents Name if Minor *

NOTE: The Skillful Living Center, Inc will not discriminate against any person on the basis of race, creed, color, national origin, marital status, gender, sexual orientation or disability.

Submit