Volunteer




Your Name (required)
Address (required)
City (required)
Your State (required)
Zip Code (required)
Your Email (required)
Date of Birth (required)
Occupation
Employer

I am interested in volunteering with

References
Please list three references, at least one of which has knowledge of your participation as a volunteer with a youth program and/or your ability to work with youth. Please include phone number and/or email address for each reference.

Previous Volunteer Experience

Why do you want to volunteer at Van Go?

Special Certifications (CPR, Medical, Etc)

Driver’s License
License Number
 Yes, I can use my vehicle to pick up kids from school.
 Yes, I can drive a Van Go vehicle to pick up kids from school.

Have you ever been convicted of or plead guilty to any crimes?

If yes, please describe.

Are there any criminal charges pending against you regarding any crimes involving a minor?

Have you ever been refused participation in any other youth programs?

If yes, please describe.

Skills/Experience

Other Skills

Availability

Additional information

As a condition of volunteering, I give permission for Van Go Inc. to conduct background check(s) on me now and as long as I continue to be active with the organization, which may include a review of sex offender registries, child abuse and criminal history records. I understand that, if appointed, my position is conditional upon Van Go Inc. receiving no inappropriate information on my background. I hereby release and agree to hold harmless from liability. I also understand that, regardless of previous appointments, Van Go Inc. is not obligated to appoint me to a volunteer position. If appointed, I understand that, prior to the expiration of my term, I am subject to suspension by the Program Director and removal for violation of Van Go’s policies or principles.