Volunteer Application

For which volunteer position are you applying?*

Name*

First Last

Address*

Street Address Address Line 2 City State ZIP Code

Home Phone*

Cell Phone

Email*

Emergency Contact Name*

Phone Number*

Area of Interest

Classroom

Marketing & Development / Auction

Kitchen

Front Desk / General Administration

One Time / Other

Location Preference*

Beacon Hill

Yesler Terrace

Administrative Office

Sand Point/Mercy Magnuson

What Day/Times are you available to volunteer?*

Hours interested in volunteering in a week

How many days a week?

How long can you commit to volunteering?

Orientations

Orientations are on the last Friday of the month at 4 PM for 30-45 minutes. Are you able to attend on one of the following months? * If unable to attend, we will schedule an individual orientation.

Are you a current or former DLEC/Head Start or DLEC parent/guardian/family member?*

Yes

List

Child's name

Years Attended

Interested in receiving agency e-newsletter?

Yes

How did you hear of Denise Louie Education Center?

Criminal Background

Please complete the following questions. Do not leave blank, please write “N/A” if not applicable. This information is required by child care licensing and Head Start Performance Standards; and will be verified through a criminal background check prior to hire.

Applications received with this section incomplete will not be considered.

Please list all pending and prior criminal arrests and charges related to child sexual abuse and their disposition*

Please list all convictions related to other forms of child abuse and neglect*

Please list all convictions for violent felonies*

Experience

Previous volunteer/work experience

Agency/Institution

City and State

Duties/Responsibilities

Supervisor

Last School Attended

Degree

Graduated

Yes

Are you a Student?

Yes

If YES, are you volunteering for credit?

Yes

School

Teacher

Telephone

Are you able to provide translation?

Yes

If YES, Verbal?

Yes

Written?

Yes

Language

References

Please list three references including at least one professional reference. Do not include names of people that are related to you by blood or marriage.

Name

First Last

Work Phone

Home Phone

Address

Street Address Address Line 2 City State ZIP Code

Relationship

Name

First Last

Work Phone

Home Phone

Address

Street Address Address Line 2 City State ZIP Code

Relationship

Name

First Last

Work Phone

Home Phone

Address

Street Address Address Line 2 City State ZIP Code

Relationship

Certification

I understand that a condition of volunteering is that Denise Louie Education Center must conduct local and national background checks. Therefore, if offered the volunteer opportunity by Denise Louie Education Center I hereby authorize Denise Louie Education Center to conduct local and national background checks for the purposes of evaluating whether I am qualified for the position. I understand that Denise Louie Education Center will utilize an outside firm(s) to assist in checking such information. I also understand that I may withhold my permission and in such a case my application will not be processed further.

I certify that the above is true and correct to the best of my knowledge. I understand that any untrue or misleading answers are cause for rejection of my application. I authorize Denise Louie Education Center to verify statements contained in this application. I authorize Denise Louie Education Center to contact references listed in this application.

I agree.

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