Volunteer Application Volunteer Application Step 1 of 6 16% Become a volunteer in three easy steps: 1. Fill out the Background Check form. 2. Fill out the Volunteer/Internship Application form. 3. Click Send Background Check Application: Applicant Authorization and Release This form will serve to advise you that a Consumer Credit Report and/or Investigative Report will be conducted on you in the course of consideration for employment, promotion or membership. This report is being provided by Identity Solutions Group, Inc. P.O. Box 689, Hampstead, MD 21074. Phone (800) 274-5951. I hereby authorize Identity Solutions Group, Inc. or any agent of your company to contact any and all corporations, former employees, credit agencies, educational institutions, law enforcement agencies, city, state, county and federal courts and military services to release information about my background including but not limited to, information about my employment, education, consumer credit history, criminal records and general public records history, driving records, to the person or company with which this form has been filled out. This releases the aforementioned parties from any responsibility and liability for collecting the above information. This release shall remain in effect for the length of my employment/membership; I understand I have the right to obtain a free copy of the Consumer Report if: (1) Any adverse action/action is made based on the information in the Consumer Report, (2) If the request is made in writing within 60 days of the adverse action. I believe to the best of my knowledge that all the information I have provided is accurate and true and correct and that I fully understand the terms of this release.Personal InformationName (Last)FirstMiddleList any maiden/other name used in the last 7 years:Date of Birth (mm/dd/yyyy) MM DD YYYY StateSexZipAddress InformationList your current mailing address as well as any other cities or towns you have lived in the past 7 years:Current AddressCityStateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificZipOther Places of residenceCityStateCountryZipFromTo SignatureWhile the information contained in the reports provided has been obtained from public records data sources deemed to be reliable, its accuracy cannot be guaranteed due to potential human error in the actual recording of the record. Since this information is not owned by Identity Solutions Group, Inc. and since public records data on any one individual, group of individuals, company or companies can be contained in more than repository, Identity Solutions group, Inc. can only rely on its accuracy from the public records data sources presently available at the time of the search. This information is furnished for your exclusive use and accepted by you without any liability on the part of Identity Solutions Group, Inc. and its officers, agents, employees or sources. Furthermore, you agree to Indemnify Identity Solutions Group, Inc. and its officers, agents, employees or sources of any liability for the use of this information and shall agree that the right to obtain information and the purpose for this information for your exclusive use is fully within the appropriate law or laws which apply to the permissible purpose of retrieving background information on an individuals criminal records history, credit history, and/or workers compensation claim history. Personal InformationHome PhoneCell PhoneBest time to reach youEmail Enter Email Confirm Email Birth Date MM DD YYYY Current OccupationEmployer/SchoolWork/School PhoneMay we call you at work?YesNoHow did you hear about volunteer opportunities at The Arc Baltimore? Fliers Internet Newspaper Volunteer Center Word of Mouth Other Other To help us match you with a volunteer opportunity that best fits your preferences, time commitment, interests, and skills, please answer the following questions.Briefly explain why you would like to volunteer:List the volunteer position(s) for which you are applying:Do you prefer: a regular/ ongoing commitment a one-time special event non-paid internship Indicate day(s) and time(s) you are available to volunteer:Weekdays: Monday Tuesday Wednesday Thursday Friday Times available during weekday: Morning Afternoon Evening Weekends Saturday Sunday Times available during weekend: Morning Afternoon Evening Education(check last year completed):Pre-college: grade 1 grade 2 grade 3 grade 4 grade 5 grade 6 grade 7 grade 8 grade 9 grade 10 grade 11 grade 12 College: 1 2 3 4 Master's Degree Doctorate ExperienceProfessional / Work ExperienceVolunteer ExperienceDescribe any special skills, training, or professional licensing that you have:Describe any areas of interest that you are hoping to learn more about by volunteering:ReferencesNameAddressPhoneEmail (List three (3) people who are not related to you who have direct knowledge of your work and volunteer experience. Complete contact information is required.) Emergency ContactIn event of an emergency notify:RelationshipDay PhoneEvening PhoneSignaturesI authorize The Arc Baltimore to contact the listed references and to verify the information provided on this application. I understand that misrepresentation or omission of facts requested is cause for non-placement as a volunteer. If placed as a volunteer, I agree to abide by the philosophies of The Arc Baltimore and to fulfill the volunteer responsibilities to the best of my abilities.SignatureDate Parent/ guardian's signature (if applicant is under age of 18)Date This application is the first step in becoming a volunteer with The Arc Baltimore. You may be required to have a criminal background check completed, other tests and other trainings, depending on the volunteer position you are applying for. Please forward this application to the office of Volunteers and Interns when completed. Fax application to: 443-279-3415 or email it to: dstaigerwald@thearcbaltimore.org . The Arc Baltimore does not discriminate on the basis of race, color, religion, national origin, age, gender, disability, marital or veteran status, political affiliation, sexual orientation, or any other legally protected status.