Volunteer Application

Please Fill Out the Form Below:

Area(s) of Interest

Available Time Commitment

Available Start Date

How did you hear about Father's Heart Ranch?
NewspaperEmployeeRadioOther

Personal Information

Your Full Name

Your Full Address

Your Telephone Number

Your Email

Are You 21 Years of Age or Older?
YesNo

Driver's Licence Number (DMV reports are required for applicants being considered for positions which will normally require them to drive for company business)

Date of Last T.B. Test

A. Have you volunteered at FHR previously?
YesNo

B. With or without accommodation, can you perform the duties of this job?
YesNo

C. Have you ever been convicted of an offense other than the following?

1. Minor traffic violations for which the fine was $50 or less before April 5, 1984 or $100 or less on or after April 4, 1984 or

2. Any offense which was finally settled in a juvenile court or under a welfare youth offender law. (Offenses which fall under numbers 1 and 2 above need not be reported)

Employment is contingent upon clearance of your criminal record by Community Care Licensing.

YesNo

D.Has your driver's license ever been suspended or revoked?
YesNo

E.If you answered "YES" to either C or D above, please provide the following information for each event: The Date, Location, Nature and Disposition of the circumstance.

Describe any specialized training, apprenticeships, skills ans extra-curricular activities:

List professional, trade business, or civic associations of which you are a member (You may exclude groups which indicate race, color, religion, sex, age or other protected status):

What foreign languages do you speak, read, or write?

State any additional information you feel may be helpful to us in considering your application:

Personal References

List three persons who are not related to you and who can give information about your background, character, abilities, etc.

Personal Reference #1

Name:

Telephone Number:

Address:

Relationship:

Personal Reference #2

Name:

Telephone Number:

Address:

Relationship:

Personal Reference #3

Name:

Telephone Number:

Address:

Relationship:

Applicant's Statement

I authorize Father's Heart Ranch to contact my personal references and I verify that all information on this application is true and accurate.

I recognize that Father's Heart Ranch reserves the right to deny any volunteer applicant using sound judgment and discernment in the decision and that Father's Heart Ranch can revoke volunteer responsibilities when deemed necessary.

I release Father's heart Ranch and all persons and organizations from all claims and liabilities of any nature arising from inquiries about the information on this application.

I understand that volunteering depends on the screening of my criminal history, TB clearance and child abuse check.

I have read and agree with the Volunteer Guidelines.

By checking "Agree" below, I electronically certify and agree to all of the above statements.
AgreeDisagree