Empowering Future Leaders



Volunteer Application

Personal Information
Name *
Birth Date *
Birth Date
Contact Information
Primary Phone *
Primary Phone
Address *
Background Information
Have you ever been convicted of a felony? *
Have you had any criminal convictions for child abuse or sex-related crimes? *
Interest Details
Are you required to volunteer? *
Professional Reference
Professional Reference
Professional Reference Name
Professional Reference Phone
Professional Reference Relation
Professional Reference Years Known
Personal Reference
Personal Reference
Personal Reference Name
Personal Reference Phone
Personal Reference Relation
Personal Reference Years Known
I hereby declare that the information provided by me in the Application for Volunteer Service is true, correct and complete to the best of my knowledge. I understand that if given the opportunity to volunteer, any misstatement or omission of fact on this application is cause for immediate dismissal. I authorize the Richard & Thelma Nesbitt Foundation (RTN) to verify any information I have provided. I release reference sources from all liability or damages on account of furnishing information regarding my personal character, habits, performance or disciplinary records. I further understand that if accepted as a volunteer at RTN, my volunteer service will be at will, and that service at RTN may be terminated with or without cause, and without notice, at any time, at the option of either RTN or me. I understand that background checks and/or fingerprints may be required as a condition of volunteering at RTN to protect youth, volunteers, board members, and the integrity of RTN.