Confidential Volunteer Application

Confidential Volunteer Application
Thank you for your interest in volunteering with StreetLightUSA! We have a variety of openings on an ongoing basis and desire to match you with the most suitable opportunity. The form below will take about 10-15 minutes to complete and there is a list of other documents to submit at the end. If you have any questions, please reach out to volunteer@streetlightusa.org

Once you have submitted your form, someone will reach out to you through email to discuss next steps.
Date of Application

MonthDayYear
Personal Information
Full Name*

First NameLast Name
Date of Birth*
Cell Phone Number

Area CodePhone Number
Alternative Number

Area CodePhone Number
Email
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
When did you move to this address?*

MonthDayYear
Date
How long have you resided in Arizona?*
Primary Language*

EnglishSpanishSigning
Secondary Language

EnglishSpanishSigning
Experience and Education Information
Employment Status*

Full TimePart TimeNot employedRetiredLooking for workNot looking
Place of Employment*
Job Title *
Previous Employment:*
If self-employed or retired- since what date?

MonthDayYear
Date
Current Schooling Status*

Part-TimeFull TimeNot in school
Where do you attend school? (If not in school you can leave line blank)
Highest Level of Education*
Name of Place of Worship (If applicable)
City and State of Place of Worship
Do you have volunteer experience? *

YesNo
How many years experience have you had working with children?*
years
Current community activities, memberships, etc.*
Brief description of hobbies, interests, skills, and areas of training/expertise*
Have you applied for a job or volunteered with StreetlightUSA in the past?*

YesNo
If Yes, please describe
Volunteer Interest
Support Roles

Admin SupportFront Desk SupportHousekeeping/CleaningFacilities/MaintenanceKitchenSecurity
Other/Offsite

Special EventsWritingAnimation/Graphic DesignResearchTelephoneSocial Media
Have a special skill you are looking to share? Let us know more!
Is this for an internship, service learning, or other schooling requirement?*

YesNo
Preferred work location*

On siteOff siteFrom home
Available times--select all that apply*

MorningsAfternoonsEveningsWeekdaysWeekends
Referred by*

ChurchColleagueFlyerFriendInternetSchool
Background Information
Do you have a valid Driver’s License?*

YesNo
Criminal History Have you ever been arrested or convicted of a crime (including a DUI)?*

YesNo
If Yes, please describe
Have you ever been convicted of neglect, abuse or substance dependency?*

YesNo
If yes, please describe
Type a question

Type option 1Type option 2Type option 3Type option 4
Do you currently hold a Department of Public Safety Level 1 Arizona Fingerprint Clearance Card?*

YesNo
References
Employment Contact Info:
Name of Contact
Phone Number

Area CodePhone Number
Email
example@example.com
Please list three (3) additional character references. If you are employed, one reference should be from your employer (different from above). PLEASE DO NOT LIST RELATIVES OR ANYONE LIVING IN THE SAME HOUSEHOLD!
Full Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Relationship*
E-mail*
Full Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Relationship*
E-mail*
Full Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Relationship*
E-mail*
I understand that I will also need to submit the following if accepted for a position on campus. Direct Care and Mentoring positions require additional certifications. Please check each to indicate acknowledgment.*

Current level 1 fingerprint clearance cardCriminal History Affidavit (needs to be notarized)Current health assessment verifying that you are free of communicable disease; recent TB Test resultsValid government issued photo IDAssumption of Risk/Waiver and other in-house forms
I,*
, hereby affirm that all of the answers provided on my application are true. I understand that misrepresentations or omission of facts called for is cause for dismissal. I hereby authorize StreetlightUSA to investigate my background and to contact the above given references for the purposes of determining my suitability as a potential volunteer/intern.
Internet Signature*
Date

MonthDayYear
E-mail*
Enter the message as it's shown*
Click to edit
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Confidential Volunteer Application

Personal Information

Experience and Education Information

Volunteer Interest

Background Information

References