Volunteer Application

It is the policy of the Quiet Storm Foundation to ensure a safe environment for youth participants in any Quiet Storm Foundation sponsored program. Therefore, perspective volunteers are asked to disclose any and all prior history of criminal convictions other than minor traffic violations. A criminal record will not necessarily bar an applicant, but all offenses will be considered by Quiet Storm Foundation members as they relate to an indication of a lack of trustworthiness and/or fitness to the specific Quiet Storm Foundation program. Volunteers working with youth are obligated to disclose any and all future arrests and also must report any and all convictions immediately.

Personal Information

Please fill out all sections completely.
Name* A value is required. Title A value is required. First A value is required. Last A value is required. Middle Int.
Other Names Used (Maiden Name, Alias, Aka, etc)
Address*
Street Address

A value is required.

Address Line 2

City A value is required.

State / Province / Region A value is required.

Postal / Zip Code A value is required.
Country
Home Phone* A value is required. - (###) A value is required. - ### A value is required. ####
Alternative Phone Number - (###) - ### ####
Email*
A value is required.Invalid format.
Employment

If “YES”, Please provide Name, address and telephone number of employer.
Are You Currently Employed?* Yes No

Please make a selection.
Name of Employer
Address of Employer
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Phone of Employer - (###) - ### ####
Do you have any disabilities, injury or illness that would prevent you from performing the duties associated with this volunteer assignment?
References*

Please provide two persons, not related to you, who have knowledge of your qualifications to work in youth development programs
Reference 1*
Name A value is required. First A value is required. Last
Address
Street Address

A value is required. Address Line 2

State / Province / Region A value is required.

City A value is required.

Postal / Zip Code A value is required. Country
Phone A value is required. - (###) A value is required. - ### A value is required. ####
Reference 2*
Name A value is required. First A value is required. Last
Address
Street Address

A value is required.

Address Line 2

State / Province / Region A value is required.

City A value is required.

Postal / Zip Code A value is required. Country
Phone A value is required. - (###) A value is required. - ### A value is required. ####
Volunteer Position*
Special Events (Hoops for Hope, Back to School Extravaganza Afterschool Program Community Involvement Fairs
Conviction Information*

If “Yes” please provide detailed information for EACH conviction below.
Have you ever been Convicted of a Misdemeanor, Gross Misdemeanor, or Felony?

Please make a selection. Yes No
Include any conditions of your and/or probation, if applicable. DUI, reckless and careless driving convictions MUST be included. A criminal does not necessarily preclude a person from becoming a volunteer. Each case is considered on its individual merits. OMISSION OF REQUESTED INFORMATION WILL REVOKE YOUR APPLICATION

Date / MM / DD YYYY
	Location (City)	Nature of Offense (Ex: Type of Charge)	Disposition (Paid Fine, Time Served, ETC.)
Date / MM / DD YYYY
	Location (City)	Nature of Offense (Ex: Type of Charge)	Disposition (Paid Fine, Time Served, ETC.)
Date / MM / DD YYYY
	Location (City)	Nature of Offense (Ex: Type of Charge)	Disposition (Paid Fine, Time Served, ETC.)
Date / MM / DD YYYY
	Location (City)	Nature of Offense (Ex: Type of Charge)	Disposition (Paid Fine, Time Served, ETC.)

Submission*
I certify that the statements made by me on this application are true, complete and correct. I understand that all voluntary assignments are subject to the successful completion of a background check and drug screening. I Accept Please make a selection.

Volunteer Application

Volunteer Application

Personal Information

Employment

References*

Reference 1*

Reference 2*

Volunteer Position*

Conviction Information*

Submission*