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Idaho Chapter Volunteer Application
MAKE-A-WISH FOUNDATION OF IDAHO REQUIRES THE APPLICATION LISTED BELOW BE FILLED OUT IN ITS ENTIREITY. IF A PARTICULAR FIELD DOES NOT PERTAIN TO YOU, MARK IT AS NOT APPLICABLE (NA). PLEASE BE ADVISED THAT YOUR APPLICATION MAY NOT BE ELIGIBLE FOR PROCESS IF YOU NEGLECT TO FULLY COMPLETE IT. THANK YOU! |
PERSONAL INFORMATION
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| First Name: |
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Last Name: |
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| Address: |
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City: | |
| Zip: |
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State: |
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| Phone Number: |
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Cell Phone: |
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| Fax Number |
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| Email Address: |
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EMPLOYMENT INFORMATION
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Employer |
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Since |
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| Position |
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Work Phone |
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May we contact your employer? |
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EMERGENCY CONTACT INFORMATION
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Name: |
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Relationship: |
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| Daytime Phone: |
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Evening Phone: |
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EDUCATION INFORMATION
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High School |
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Date Completed |
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| College |
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Degree |
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Date Completed |
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VOLUNTEER EXPERIENCE
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Organization Name |
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Volunteer Position |
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Contact |
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Phone |
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Organization Name |
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Volunteer Position |
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Contact |
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Phone |
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| Have you ever been asked to relinquish a volunteer position? |
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PERSONAL REFERENCES
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Name |
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Relationship |
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Phone |
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Name |
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Relationship |
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Phone |
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OTHER
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Do you hold a valid driver's license? |
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License number: |
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| State issued: |
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Expiration Date: |
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| Have you ever had your driver's license suspended or revoked? |
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Background Check Consent Form
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| As a condition of your potential service to the foundation as a volunteer, Make-A-Wish Foundation, of Idaho will perform a background investigation. Inquiries into criminal backgrounds are necessary and are being posed solely because of the potential for ensuing relationships with the wish children and their families. Your participation in this process is voluntary however, if you choose not to consent by means of not signing this release, you will be eliminated as a possible candidate for a volunteer position. All information will be kept confidential! A donation of $7.00 is requested to defray the cost for the foundation.
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| Name: |
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| Address: |
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| City: |
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State: |
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Zip Code: |
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Do you have any prior
names or surnames: |
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Date of birth: |
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Place of birth: |
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Social Security Number: |
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| Do you use illegal drugs? |
Yes
No
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| Are you currently charged with a criminal offense including
but not limited to, criminal neglect, abuse or assault?
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Yes
No
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| Have you ever been convicted of a criminal offense, including
but not limited to, criminal neglect, abuse or assault?
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Yes
No
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| Do you agree to disclose any future criminal convictions or
violations?
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Yes
No
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| Have you ever been convicted of a crime against children or
other persons?
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Yes
No
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| Have you ever been convicted of crimes relating to financial
Exploitation if the victim was a vulnerable adult?
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Yes
No
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| Have you been found in any dependency action to have
sexually assaulted, exploited or physically abused any minor?
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Yes
No
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| Have you been found by a court in a domestic relations
proceeding to have sexually abused or exploited any minor
or to have abused any minor?
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Yes
No
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| Have you been found in any disciplinary board final
decision to have sexually or physically abused or
exploited any minor or person with a developmental
disability or to have abused or financially exploited
any vulnerable adult?
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Yes
No
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| Have you ever been found by a court in a protection
hearing to have abused or financially exploited a
vulnerable adult?
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Yes
No
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