Boys & Girls Clubs of Cleveland · A- Volunteer Application

Volunteer Application

Thank you for your interest in becoming a volunteer with the Boys & Girls Clubs. Please give the volunteer coordinator up to four weeks to process your application. The first step in becoming a volunteer is completing the application below. Please note, it is very important that you provide complete contact information from two non-family references. We cannot process your application if this information is incomplete. Upon completing your application, click the "Continue" button at the bottom. Please allow up to four weeks to receive confirmation that you application has been received and is being processed. If you have any problems completing the on-line application or have any questions about our volunteer program, please contact us 330-773-3375.

Personal Information

Name

*

First Name

Last Name

Email

*

Verify Email

*

Primary Phone Number

*

Work Phone

Address

*

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Volunteer Type

Birthdate

*

(mm/dd/yyyy)

Gender

*

Emergency Contact

Person to Notify in Case of Emergency

*

First Name

Last Name

Emergency Contact Phone

*

Emergency Contact Secondary Phone

Relationship

Education

Years of High School

*

High School Name

Are you or did you attend college?

*

Yes

No

Years of College

*

Major

College(s) attended

*

Experience

Military Service

Club Employee?

*

Current B&G Club Employee

Never Employed by the B&G Club

Prior B&G Club Employee

Club Volunteer?

Job Title

Organization/Employer

Employer Name 2

Organization Name 1

Organization Name 2

You may use this box to provide additional experience information

Volunteer Organization Name

Skills and Talents

You may use this box to provide additional skills and talents information

Opportunity Preferences

Eller Teen Club

LeBron James Club

Steve Wise Club

You may use this box to provide additional areas of interest

Demographic Information

Race/Ethnicity

African American

Asian

Hispanic/Latino

Multi-Racial

Native American

Caucasian

Other

Prefer not to answer

Email Preferences

We like to keep volunteers informed of important news, schedules, and volunteer opportunities by email, however will not send you any email you prefer not to receive. Use the checkboxes below to select the kinds of email you would like to receive from us.

Electronic newsletters

Recruitment appeals

References

You are required to submit two references. One reference must be from someone in a leadership/advisory role (i.e. teacher, clergy, counselor, employer).Relatives are not accepted as references.

Students must provide a teacher or guidance counselor as a reference.

Reference 1 Name

*

First Name

Last Name

Reference 1 Address

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Reference 1 Organization/Employer

Reference 1 Phone

*

Reference 1 Relationship

*

Reference 2 Name

*

First Name

Last Name

Reference 2 Address

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Reference 2 Organization/Employer

Reference 2 Phone

*

Reference 2 Relationship

*

Statement of Applicant

*

By submitting this application, I affirm that the facts set forth in it are true and complete. I understand that if I'm accepted as a volunteer, any false statements, omissions, or other misrepresentations may result in my immediate dismissal. I understand that my current employer, the volunteer site that I have listed in my application and law enforcement/criminal records agencies may be contacted by Boys & Girls Clubs of Cleveland on my behalf.

Yes

No

Background Check

Ohio resident for the past 5 years?

*

Yes

No

Convicted of a law violation?

*

Yes

No

If you have ever been convicted of a violation of the law other than a minor traffic violation, please identify under what name, location, charge and current status of charge.

Background Check

We do conduct both initial and annual background screenings. A conviction does not necessarily disqualify an applicant. Failure to disclose may result in disqualification or termination.

Social Media Policy

*

I understand volunteers are prohibited from being “Friends” on Facebook, or “Followers” on Twitter, or engaging in any other kind of personal relationship via social media outlets with Club members under the age of 18.

Yes

No

Consent

Health and Safety

I understand that, in participating in the Boys & Girls Clubs of the Western Reserve (“the Club”) Volunteer Program, I/my child will be exposed to the normal risks of a Club visitor or staff member.

I understand and agree that I waive for myself, my child and any heirs any and all claims including any negligence claims which I or my child might have against the Club, or its agents or representatives, in any way arising from or relating to the Volunteer Program, except for claims arising out of the gross negligence or reckless or willful misconduct of the Club or its agents, or representatives. I hereby agree that I will not sue the Club on behalf of myself or my child, nor will my child sue on his/her own behalf, and release the Club from any claims I/my child, may have against it except for gross negligence or willful or reckless misconduct on the part of the Club, its trustees, officers, agents and employees.

Background Check

I authorize the Club to use all legal means at its disposal to assess my suitability for volunteerism including obtaining a "consumer report" (criminal background record check) about me from a "consumer reporting agency" and consider such reports when making decisions about my volunteer application. I understand and agree that the Club or any agent acting upon their behalf, as well as any other person responding to a reference request pursuant to this application, can and will seek and/or disclose any and all information about me which said corporation, agent, or person may have. I specifically authorize said disclosure and agree to hold such corporations, agents, or persons harmless for same. That is, I will not file a lawsuit, claim or charge against them for such disclosure. Nor will I threaten same or otherwise seek any kind of compensation for such disclosure. I further release the Club, its officers, partners, affiliate agents and assigns from all liability or damages caused by inquiries regarding statements made in any "consumer report" accessed by the Club. I also understand and agree that the criminal background check may include a fingerprinting requirement and drug screening.

Publicity

I understand that the Club may use photographs, videos or other likenesses of myself or child captured during the course of volunteering and use them for work related to the Club.

Submission of Application

By submitting this form, I certify that all information I have supplied in this volunteer application and any other form, oral or written, is true and accurate, and I agree that any misstated, misleading, incomplete, or false information is grounds for rejection of this application form, refusal to be accepted as a volunteer or immediate discharge from the volunteer program without recourse, whenever and however discovered.

I understand and agree that submitting this application form does not automatically register me as a volunteer, and that there may be certain qualifications I must meet, including the acceptance of established volunteer policies and procedures before I may begin volunteering. By signing/submitting this form, I agree that I have read, understand, and agree to the terms of this consent form, or in the alternative, that I have read this form to my child and he/she understands and agrees to its terms. I give my full consent to my/my child’s participation in the Volunteer Program.

Applicants 18 years old (still in school) and younger must have a parent/guardian sign below.

This is an equal opportunity organization.

Typed Volunteer Name for Consent

*

Typed Parent Name for Consent

Background Check Release

*

I hereby authorize Boys & Girls Clubs of the Western Reserve or other authorized representatives of the Agency bearing this Release, or copy thereof, within one year of its date, to obtain any information in your files pertaining to any felony convictions through First Advantage National Criminal File, sexual offences through the National Sex Offender Registry (Dept. of Justice) and for Social Security Number Verification. I understand if any misdemeanors are listed that the Boys & Girls Clubs of the Western Reserve reserves the right to determine if I can continue as a volunteer. I hereby direct you to release such information upon request of the bearer. I hereby release you, as the custodian of such records, and any law enforcement agency, including its officers, employees, or related personnel, both individually and collectively, from any and all liability for damages of whatever kind which may at any time result to me, my heirs or associates, because of your compliance with this authorization and request to release information, or any attempt to comply with it or the nature of the information you provide. This Release is executed with the full knowledge and understanding that the information will be used in connection with the consideration of my volunteering by Boys & Girls Clubs of the Western Reserve. Should there be any question as to the validity of this Release, you may contact the Agency as indicated above.

Yes

No

I Agree

I understand and agree that submitting this application form does not automatically register me as Boys & Girls Club volunteer, and that there may be certain qualifications I must meet, including the acceptance of established volunteer policies and procedures before I may begin volunteering.

By submitting this form, I attest that the information I have provided on the form is true and accurate.

*

I agree