The Springs-Adult Volunteer Form 18+

Name *

First Name Last Name

Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

Phone Number *

Area Code Phone Number

E-mail

Date of Birth *

Month Day Year

Any other city/states you have lived in?

Church you attend:

Pastors Name:

Are you a member?

Yes No

Other churches you have attended:

Areas you have volunteered or served at church:

Occupation *

How long at this job? *

Other places of employment?

List areas of interest as a volunteer at The Springs:(such as maintenance, gardening, baking, cleaning, painting, etc...) *

How often are you willing to volunteer? *

Weekly Entire Summer As Needed Certain Projects Call when needed

List weeks of the summer you are available: *

Have you ever been accused of or involved in any type of sexual misconduct or abuse? *

No Yes

Have you been involved in or convicted of any other type of legal issues other than a minor traffic violation? *

Yes No

If Yes, please explain:

Contact References: List two people and thier phone numbers below. Please do not use your pastor as he/she is already listed above.

Reference #1 *

First Name Last Name

Reference #1 Phone Number *

Area Code Phone Number

Reference #2 *

First Name Last Name

Reference #2 Phone Number *

Area Code Phone Number

We are licensed under state child care regulations. We also, under good conscience, try our best to protect our children inour carre from any type of concern or danger. Every volunteer goes through this type of screening. Thank you for applying to volunteer. If you have any concerns regarding your opportunity to volunteer, feel free to call the camp office and speak with our director. We will process you application and give you a call back to discuss with you about becoming a volunteer.

Please upload a recent photo of yourself. *

Signature *

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