Joshua's Camp Volunteer Application

Fields marked with an asterisk (*) are required.

Personal Information

Name *

Former Name

Birth Date *

Sex * Please identify your sex

Address *

City / State / Zip *

Home Phone *

Work Phone

Cell Phone

Best Time To Call

E-mail Address *

Previous Address (If you have lived at your current address for less than 5 years)

Address

City / State / Zip

Emergency Contact Information

Emergency Contact *

Emergency Contact Relationship *

Emergency Contact Info *

Current Employer

Employer Name

Employer Address

Employer Phone

Job Title

Length of Employment

Supervisor Name

Supervisor Phone

Volunteer Work

Volunteer Work #1

Add Volunteer Work

Special Interests

Skills

Availability

References (Give complete information for two non-relatives)

Reference #1

Add Reference

Confidentiality

I agree to treat any specific personal information I may gain through my volunteer work/service with Joshua's Camp with absolute confidentiality.

Confidentiality Signature *

Date *

Criminal Background

Have you ever been charged or convicted with any crime, other than a minor traffic offense? * Yes No

If Yes, please explain

Application Signature

Acceptance as a Joshua's Camp volunteer is subject to a Criminal Background Check with NO RECORD and a positive response from two references provided above.

AUTHORIZATION FOR CONDUCTING BACKGROUND CHECK FOR THE PURPOSE OF ACTING AS A VOLUNTEER FOR JOSHUA'S CAMP CORPORATION:

Applicant Signature *