ALFAL Youth Enrichment Center

Volunteer Application

First Name
Last Name
Address
City
State
Zip Code
Area Code and Phone NumberForma:t 555-555-5555
E-mail Address
Citizenship
Social Security NumberFormat 555-55-5555
Gender
Date of BirthFormat MM/DD/YYYY
EMERGENCY CONTACT INFORMATION
NameFirst and Last Name
Relationship
Area Code and Phone NumberFormat 555-555-5555
Doctor's Name and Contact Info
Preferred Hospital
REFERENCES
Reference 1 - Name, Address, and Phone
Years Known
Reference 2 - Name, Address, and Phone
Years Known
GIFTING/INTERESTS/SPECIAL SKILLS
What are your areas of gifting?
What areas would you like to volunteer in?
Have you ever volunteered for A Life For A Life International
If Yes, When
Which Program?
Days of the week available
Hours Available
Please answer the following questions.  If yes to either, please explain
Have you ever been convicted of a felony?
Have you ever been convicted of a misdemeanor?
If yes to either question, please list charge and date of offense:
Have you ever been the subject of disciplinary action, or been in part responsible for a child care facility receiving an administrative fine or other disciplinary action?
If yes, please explain:
I hereby authorize A Life For A Life International, Inc. and/or the company of its choice to conduct an independent investigation of my background, references, criminal or police records or other registries as deemed necessary or other information which may be material to my qualifications for volunteering.

I understand all information will be kept in my personal file.  I certify that the information I provided in this application is true and complete to the best of my knowledge.
Signature
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