dev-form - Hope for Prisoners

Personal Information

Name*

First Last

Address*

Street Address Address Line 2 City State ZIP Code

Phone Number*

Email Address*

Date of Birth*

Gender*

Male
Female

Employment

Are You Currently Employed?

Yes
No

Are You Working Full Time or Part Time?

Full-Time
Part-Time

Name of Employer

Position

Do you have adequate transportation?

Yes
No

Education

Highest level of education completed

Diploma?

Yes
No

College/University attended

Dates Attended From

Dates Attended To

Do you speak any other languages fluently?

Yes
No

If Yes Which Languages

Additional Information

Please describe any past volunteer experiences:

What clubs and/or community organizations are you affiliated with?:

Do you have any experience with violence prevention or counseling agencies (physical abuse, sexual assault, emotional abuse, and/or neglect)? If so, please explain

Have you ever been convicted of a felony or serious misdemeanor crime?

Yes
No

If yes, please state the nature of the crime(s), when and where convicted, and disposition of the case(s):

References

Please list two (2) adults who have known you in a professional capacity for at least one (1) year:

Name

First Last

Address

Street Address Address Line 2 City State ZIP Code

Phone Number

Relationship

Name

First Last

Address

Street Address Address Line 2 City State ZIP Code

Phone Number

Relationship

Name

First Last

Address

Street Address Address Line 2 City State ZIP Code

Phone Number

Relationship

How did you hear about HOPE for Prisoners?

What strengths do you feel you can offer as a volunteer / mentor?

If selected as a mentor, please indicate your area(s) of interest (check all that apply):

Outreach
Fundraising
Job Training
Education
Research
Public Relations
Mentoring

Is there anything else that you would like us to know about you?

Please read the following carefully before submitting:*

I certify that all statements contained in this application are true and correct to the best of my knowledge. I understand that misrepresentation or omission of facts is cause for dismissal. I further understand that any offer to work with HOPE for Prisoners and or the segment of the population that we serve is subject to completion of a background investigation and the volunteer/mentor training course.

I give my consent to any person, firm, or organization listed here to furnish HOPE for Prisoners with information concerning my character, past employment, or other information pertinent to my volunteer/mentor position with HOPE for Prisoners.

Accepted Terms*

I agree to the Terms of Service

Personal Information

Employment

Education

Additional Information

References

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