Volunteer Form

* Indicates required field

Name (First and Last) *

First

Last

Address *

City *

State *

Zip Code *

Email *

Cell Phone Number *

Home Phone Number *

Work Phone Number *

Date of Birth *

Gender *

Male Female

Interests *

What are some of your interest, talents, skills, training or gifts?

Hobbies *

What do you like to do on the weekend or during your time off?

Volunteer Agreement

I hereby authorize that... *

I understand that for the safety of students/workers and in adherence to our privacy policy, there will be no exchange of contact information between myself and any minor. I understand that I may be required to undergo a background check if I request to work with minors, and that I will comply with such request prior to beginning my volunteer work with the Crosswalk Teen Center. I authorize the Crosswalk Teen Center to use video, photographs, electronic images and/or audio recordings in which I appear for public relations purposes. I do not have any criminal/civil convictions that would exclude my volunteering with teens. I understand that falsification or significant omissions of any information may be considered justifications for dismissal if discovered at a later date.

You must agree to and check the boxes above to submit a valid volunteer application.