The Hamilton Dream Center

Personal Information

Title: Mr. Mrs. Ms. Miss.

Full Name*:

Address*:

City*:

Postal Code*:

E-mail:

Phone (Home)*:

Phone (Cell):

May we call you at work? Yes No

Drivers License #:

Place of Employment:

Date of Birth (mm/dd/yyyy)*:

Sex: Male Female

Volunteer Information

What areas would you like to work?

Are you currently involved with any other organization in a volunteer position? If yes, please specify:

Do you have any physical limitations or conditions? If yes, please specify:

What days/evenings are you available to volunteer?*

List any educational qualifications, training or other characteristics that you feel are strengths:

List any personal qualities or characteristics that you feel need to be strengthened or developed further in your life:

Do you speak any languages other than English?

Do you have any first aid training? If yes please explain:

Background Check

Due to the possibility that your volunteer position may include involvement with the members of our community, especially children, it is our legal and moral responsibility to take every precaution for their safety and care as well as the Center at large. Therefore, the following sensitive questions must be asked and answered to ensure the utmost safety and community accountability as a charitable organization. (Please remember this form is confidential).

Have you ever been convicted of child abuse or of a crime involving sexual misconduct/abuse of a minor?
Yes No

Have you ever been convicted of any other crime? If yes, when?

Depending on what level of service you wish to pursue with our organization, a criminal background check may be required at your own expense. Are you willing to submit such documentation for our files?
Yes No

Personal References

At least two of these references must be completed, and only one is permitted to be a family member.

• Name*:
  

  Address*:
  

  Phone*:
  

  Relation*:
  

• Name*:
  

  Address*:
  

  Phone*:
  

  Relation*:
  

• Name:
  

  Address:
  

  Phone:
  

  Relation:
  

Application Statement

The information contained in this application is accurate to the best of my knowledge. I authorie any references or organizations listed in this application to give you any information they may have pertaining to my character and fitness to work within The Hamilton Dream Center. I authorize The Hamilton Dream Center to conduct any other reference checks they may deem appropriate. I release all such references from liability for any damage that may result from furnishing such evaluations to you and I waive the right I have to inspect the references provided on my behalf.

Should my application be accepted, I agree to be bound by the policies and procedures of The Hamilton Dream Center. I am willing to commit to this position for a period of:
6 months
one year
(please choose one).

  Submit