Volunteer Application

Name*

First Middle Last

Email*

Cell Phone*

Birthday*

Ethnicity*

Pronouns

Gender*

Maiden Name

If applicable

Any other aliases

If applicable

Driver's License Number*

Driver's License State Issued*

Height*

Weight*

Hair Color*

Eye Color*

Place of Birth*

Please list any permanent identifying marks or tattoos

Social Security Number*

Address*

Street Address Address Line 2 City State ZIP Code

Employer

Job Position

Work Phone

Are you a Boys & Girls Club Alumnus?*

Yes
No

Have you ever worked or volunteered for a Boys & Girls Club?*

Yes
No

If you answered "Yes" to the above question, please tell us which Club location you volunteered or worked for.

What is your volunteer experience?*

What is your experience working with youth?*

Why are you interested in volunteering with the Boys & Girls Clubs of Benton and Franklin Counties?*

What Club site(s) are you interested in volunteering at?*

Please check all that apply

Pasco Clubhouse
Kennewick Clubhouse
Prosser Clubhouse
Club Care Sites / Pasco
Club Care Sites / Richland
I'm not sure
I want to help where the greatest need is

Is there a specific volunteer opportunity you would like to participate in?*

Please check all that apply

Homework Help
STEM Progamming
Art / Music Programming
Teen Programming
Games Room Fun / Supervision
General Mentorship Opportunities
Club & Building Maintenance
I'm not sure
I want to help where the greatest need is

Do have any specific skills or hobbies that you are interested in / knowledgeable about that you may be able to share with our youth in a volunteer setting? Please explain.

Any health concerns or allergies we should be aware of?*

Have you ever been arrested?*

Yes
No

Have you ever been convicted of a felony?*

Yes
No

Are there any outstanding warrants out against you?*

Yes
No

If you answered "Yes" to any of the above three questions, please explain

Have you lived in the Tri-Cities area for more than the past three years?*

Yes
No

If not, please list all states / countries of residence over the last three years

Please provide the name of a reference we may call*

First Last

Please provide the phone number for your reference*

Please provide the name of a second reference we may call*

First Last

Please provide the phone number for your second reference*

Please provide the name of an emergency contact*

First Last Relation

Please provide the phone number for your emergency contact*

Please provide the name of a second emergency contact*

First Last Relation

Please provide the phone number for your second emergency contact*

Volunteer Agreement

By typing your name below, you are agreeing to our Volunteer Agreement:

- No child is permitted to leave the Club with a volunteer.

- Inappropriate language or physical contact with a member is unacceptable and will result in immediate dismissal.

- Any discipline issues must be handled by a staff member. Any and all issues, regardless of severity, must be reported to the volunteer’s immediate supervisor before the day’s end.

- No activities can be conducted outside the Club (e.g., transporting members, overnight trips, field trips, etc.).

- I agree to remain within the scope of the job description and/or assigned duties.

- I agree to complete a volunteer orientation.

- I agree to support the Club staff and Board of Directors as they create and define the vision for the organization.

First Last

Background Check Agreement

The Boys & Girls Clubs of Benton and Franklin Counties runs a thorough background check on all volunteers.

By typing your name below, you are hereby giving permission to the Boys & Girls Clubs of Benton and Franklin Counties to run and complete a full background check of yourself and your personal records.

First Last

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