Volunteer for Adaptive Programs

Position Details

Department Desired:*

Youth & Adult Sports
Youth Arts & Crafts
Outdoor Experiences
Community Events
Adaptive Programs

Volunteer Position Desired*

What is your motivation to volunteer for this position?*

What experience do you have working with youth?*

List any formal training that you have completed that is related to this position:*

Do you have Auto Insurance?*

Yes
No

Name of Auto Insurance Company

Your Information

Please note you will be required to provide social security number, proof of citizenship or immigration status, and a valid drivers license in person based on consideration of application.

Full Legal Name of Applicant:*

First Middle Last

Other Names (Maiden, Alias, etc.)

Email*

Phone*

Present Address*

Street Address Address Line 2 City State ZIP Code

Previous Address

Street Address Address Line 2 City State ZIP Code

(List address if not at the current address five (5) years)

Have you ever been convicted of a violation of the law other than a minor traffic violation?*

No
Yes

If yes, please explain:*

Have you ever had, or do you currently have a problem with drugs and/or alcohol?*

No
Yes

If yes, please explain:*

Do you have a valid driver’s license?*

Yes
No

(Proof of valid driver's license will be required upon employment)

Are you currently employed?*

Yes
No

Employment Details

List below present and past employment, beginning with your most recent.

Employer:

Address:

Phone:

Starting Date:

Starting Pay:

Starting Title:

Ending Date:

Ending Pay:

Ending Title:

Job Responsibilities / Reason for Leaving:

Describe the work you did:

May we contact?

Yes
No

(by choosing yes, you give permission to contact the employer listed above concerning your prior/current work experience)

If no, please explain:

References

List person(s) not related to you that can be contact as references

Reference #1

Name

Address

Phone

Email

Reference #2

Name

Address

Phone

Email

Reference #3

Name

Address

Phone

Email

Please Read & Accept Below

I understand and agree that:

The Great Bend Recreation Commission can deny any applicant for any reason or for no reason.
This application is valid for one (1) year.
By submitting this application, I the applicant, affirm that all the foregoing information I have provided is true and correct.
By submitting this application, I the applicant, agree (in return for being permitted to volunteer) that is any of the foregoing information is incorrect, I will forever indemnify and hold the Great Bend Recreation Commission harmless for any acts or omissions on my behalf as they relate to any incorrect information that I have provided.
By submitting this application, I the applicant, voluntarily waive my privacy rights to the extent necessary for the youth organization to verify the foregoing information through any reasonable means, including, but not limited to local, state, national and international criminal background checks and to inform those within the Great Bend Recreation Commission who are responsible for accepting and/or supervising volunteers.

Please choose the following*

I accept the Great Bend Recreation Volunteer Application Agreement
I do not accept

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Volunteer for Adaptive Programs

Adaptive Programs Volunteer for Adaptive Programs

Great Bend Rec Apply Online

Position Details

Your Information

Employment Details

References

Reference #1

Reference #2

Reference #3

Please Read & Accept Below

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