|
Name: |
|
|
|
| |
Last |
First |
Middle |
|
Email Address: |
|
|
|
|
Are you over 18? |
Yes
No |
Social Security
#s |
|
|
Present Address: |
|
|
|
City:
|
|
State:
|
Zip:
|
|
Home long at
this address: |
|
Are you able to
work in the US legally? |
|
|
Home Phone: |
|
Cell Phone: |
|
|
Alias (or other
names you have gone by): |
|
|
I have chosen to volunteer at The
Buffalo Christian Center because? |
|
|
What area would you like to
volunteer? |
|
| |
|
|
|
|
Education |
|
|
|
|
High School |
|
Graduate?: |
|
| |
|
College or Technical Training:
(School attended, degrees earned and dates of
Completion): |
|
|
Professional Licenses, special
training or skills: |
|
| |
|
|
|
|
Previous Work Experience |
|
|
|
List all employers you have had
during the past 5 years, starting with the
present or most recent employer: |
| |
|
|
|
|
1.
|
|
|
|
|
Firm |
Address |
City |
State |
| |
|
|
|
|
|
|
|
|
|
Supervisor |
Position |
Employed From |
Employed To |
| |
|
|
|
2.
|
|
|
|
|
Firm |
Address |
City |
State |
| |
|
|
|
|
|
|
|
|
|
Supervisor |
Position |
Employed From |
Employed To |
| |
|
|
|
3.
|
|
|
|
|
Firm |
Address |
City |
State |
| |
|
|
|
|
|
|
|
|
|
Supervisor |
Position |
Employed From |
Employed To |
| |
|
|
|
|
Previous Volunteer Experience |
|
|
| |
|
|
| |
|
|
|
|
References |
|
|
|
|
Present Church: |
|
| |
|
|
|
|
Present Pastor's
Name: |
|
Phone: |
|
| |
|
|
List other Churches you've
attended regularly the last 5 Years |
|
|
Church |
|
Address: |
|
|
Dates Attended |
|
Pastor |
|
|
Reason for leaving: |
|
| |
|
|
|
|
Church |
|
Address: |
|
|
Dates Attended |
|
Pastor |
|
|
Reason for leaving: |
|
| |
|
|
|
|
List below 3 personal references
you have known for at least 1 year and have a
definite knowledge of your character and ability
to work with children |
| |
|
|
|
|
1:
Name: |
|
Relationship: |
|
|
Length of time known: |
|
Phone: |
|
| |
|
|
|
|
2:
Name: |
|
Relationship: |
|
|
Length of time known: |
|
Phone: |
|
| |
|
|
|
|
3:
Name: |
|
Relationship: |
|
|
Length of time known: |
|
Phone: |
|
| |
|
|
|
|
Have you ever been convicted of
or pled guilty to a crime, either a misdemeanor
or felony (including but not limited to
drug-related charges, child abuse, other crimes
of violence, theft, or motor vehicle, theft, or
motor vehicle violations)? |
| |
|
|
No
Yes |
|
If yes please explain: |
|
|
|
| |
|
| |
|
|
|
|
I agree and represent that the
information contained in this application is
correct to the best of my knowledge. I
understand and agree that providing false and
misleading information on this application is
grounds for immediate dismissal, if I am
selected for employment. |
| |
|
|
|
|
|
|
|
|
Print Name |
|
Signature (Enter your Initials) |
Date |