Volunteer Application (Page 2 of 3) in pdf

IMPORTANT – PLEASE READ THIS

You must complete questions I, II, & III only if the position(s) for which you are applying will

involve substantial contact with children or other vulnerable individuals, i.e. elderly, mentally

or emotionally handicapped, etc.

I. Has a complaint (civil, criminal, or otherwise) ever been filed against you that alleged any

inappropriate conduct with minors, sexual misconduct, or child abuse by you (including

internal complaints given to management or supervisors at places of employment)? ____

YES ____NO

If yes, please explain. Please include in your explanation the offense alleged and the disposition

of the matter, including: the date and jurisdiction of any conviction; guilty plea; nolo contendere

plea (no contest); finding of guilt following a trial; or, the receipt of probation before judgment.

____________________________________________________________________________________

II. Has a complaint (civil, criminal, or otherwise) ever been filed against you that alleged your

participation in, facilitation of, or failure to report any inappropriate conduct with minors,

sexual misconduct, or child abuse by another (including internal complaints given to

management or supervisors at place of employment)?

____YES ____NO

If yes, please explain. Please include in your explanation the offense alleged and the disposition

of the matter, including: the date and jurisdiction of any conviction; guilty plea; nolo contendere

plea (no contest); finding of guilt following a trial; or, the receipt of probation before judgment.

_____________________________________________________________________________________

III. Have you ever chosen not to continue any employment, had your employment terminated,

or been subject to any disciplinary action, for reasons relating to allegations of

inappropriate conduct with minors, sexual misconduct, or child abuse by you?

_____ YES

_____NO

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Volunteer Application Page 2