volunteer application - Children's Home Society
volunteer application - Children's Home Society
volunteer application - Children's Home Society
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Please list three persons not related to you whom you have known for at least one year. Choose from the<br />
categories listed below; no more than one per category.<br />
___ current employer ___ instructor ___ character<br />
___ former employer ___ clergy ___co-worker<br />
___ <strong>volunteer</strong> supervisor<br />
1. Name (Mr. Ms.) _____________________________________ Relationship ___________________<br />
Address _____________________________________________________________________<br />
<strong>Home</strong> Phone ____________________________<br />
Work Phone ________________________<br />
2. Name (Mr. Ms.) _____________________________________ Relationship ___________________<br />
Address _____________________________________________________________________<br />
<strong>Home</strong> Phone ____________________________<br />
Work Phone ________________________<br />
3. Name (Mr. Ms.) ____________________________________ Relationship ___________________<br />
Address _____________________________________________________________________<br />
<strong>Home</strong> Phone ____________________________<br />
Work Phone ________________________<br />
4. Name (Mr. Ms.) ____________________________________ Relationship ___________________<br />
Address _____________________________________________________________________<br />
<strong>Home</strong> Phone ____________________________<br />
Work Phone ________________________<br />
In addition to references and central registry, it may also be necessary to complete a criminal background<br />
check and be finger printed.<br />
________________________________________________________ ______________________<br />
Your Signature<br />
Date<br />
Please return this completed <strong>application</strong> to: Volunteer Coordinator<br />
<strong>Children's</strong> <strong>Home</strong> <strong>Society</strong><br />
PO Box 1749<br />
Sioux Falls SD 57101-1749
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