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Volunteer Application

Application For Volunteer Service

Date:
Name:         
Address:  
City:
State & Zip: 
email:
Home Phone:
Work Phone:  
Cell:
Occupation: 
Employer:  
Emergency Contact Name & Phone

Education History (high school graduate; degree; college?)

How did you learn of the Children’s Village Volunteer Program?
Hobbies/Special Interests: (music, computers, the arts, carpentry, sports, language, etc.)

Have you held other volunteer jobs?  Please list:     

Personal attributes and reasons for wanting to work with emotionally disturbed children:

Check areas of possible interest:

Individuals Groups
School/classroom
Sports/Recreation
Work sites
Cottages
Chapel
Tutoring
Books for Boys
Computers
Internship
Adopt-a-Cottage
Sports/Recreation
Special Events or Projects
Other
Other

A fingerprint check, DMV check and clearance from NY State Central Registry are required for any individual volunteer position involving unsupervised off-campus trips with boys. this will be done confidentially through CV's Human Resources Dept. Photo IDs will be provided. A drug screening and tuberculosis (TB) test will be administered by our Medical Services Department. Proof of TB screening within the past 12 months will be accepted.

Do not click "submit" unless you agree to the following:
I certify that all of the above information is true and accurate and give my permission to contact the above-named references.

A fingerprint check and clearance from NY State Central Child Abuse Registry are required for any individual volunteer position. This will be done confidentially through CV’s Personnel Dept.  Photo IDs will be provided.  A drug test will be completed at CV prior to commencement of volunteer work.

Please complete reference/waiver information on the back

CV reserves the right to accept or reject an applicant without explanation