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Volunteer Info./How to Join | Contributions
Disclosure Information
The responsibilities of ICO volunteers and leader and contact with at-risk youth require that each applicant complete a screening process. Please provide the following:
Three References : Phone Number and Address
Business _______________________________________________
Friend _________________________________________________
Relative ________________________________________________
Please enclose copies of:
1. Valid drivers License (this information may be used to check for past criminal misconduct. Prior charges/convictions do not automatically disqualify candidates).
2. Current First Aid, CPR cards
Name: _________________________________________________
Address: _______________________________________________
_______________________________________________
Birth Date: ________ Social Security Number: _______________
Employer: ______________________________________________
Employer Contact: _______________________________________
Job Title: _______________________________________________
Understanding that the Boys & Girls Clubs of Metro Atlanta needs to assure the safety of its members, I hereby authorize the organization to receive any criminal history record information pertaining to me which may be in the files of any state or local criminal justice agency I Georgia. I also hereby authorize the Boys and Girls Clubs, with limitation, to copy, publish, exhibit or distribute photographs or video tapes of my volunteer activities for the purpose of reporting or promoting volunteerism. I waive all rights I may have against your organization, and/or its agents, subsidiaries or assignees related to the above photos and videos.
Signature: __________________________ Date: ______________
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