Volunteer Application

Gracious Hearts is an Equal Opportunity Employer and will select and place volunteers in assignment based on skills, interests, and experience and without regard to race, color, religion, gender, national origin, age, disability, or any other legally protected status. The following information is not required, but is needed for tracking and grant application purposes. We would appreciate your responses.

Date of Submission *

First Name *

Last Name *

Date of birth *

Email *

Phone *

Address *

City *

State *

Postal code *

Gender *

Race *

Kindly share your reasons for wanting to volunteer at Gracious Hearts and what you aim to achieve from your experience with us.

Degree of Course of Study

Name of School

Are you employed?

Yes

Have you ever been convicted or pled guilty before a court for any federal, state, or municipal criminal offense? (Exclude minor traffic misdemeanors.) If yes, please provide details below. *

Yes

Details of Conviction

I hereby affirm that the information provided on this application is true and complete to the best of my knowledge, and agree to have any of the statements checked by the organization or its representatives. I understand that providing any false or misleading information or any omissions may disqualify me from further consideration as a volunteer and may result in my immediate removal from the Volunteer Program even if discovered at a later date.

I am an applicant for volunteerism with Gracious Hearts and have been advised that as a part of the application process, the agency conducts a criminal history background check. I do hereby consent to the agency's use of any information provided during the application process in performing the criminal history check. The agency has informed me that I have the right to review and challenge any negative information that would adversely impact a decision to offer volunteer opportunities to me. In addition, I have been informed that I will have a reasonable opportunity to clear up any mistaken information reported within a reasonable time frame established within the sole discretion of the agency. Under the Fair Credit Reporting Act, I have been advised that upon request I will be provided the name, address, and telephone number of the reporting agency as well as the nature, substance, and source of all information.

I Consent to Receive SMS Notifications, Alerts & Occasional Marketing Communication from company. Message frequency varies. Message & data rates may apply. Text HELP to 1 888-365-2203 for assistance. You can reply STOP to unsubscribe at any time.

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Applicant Signature

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