Please complete this application form if you are interested in becoming a Five Pearls Foundation volunteer. Once you complete the form, click the submit button at the bottom.

Contact Information

First name:

Last name:

Middle name:

Title:

Employer:

Street 1:

City:

State:

* Zip: *

Preferred Phone phone:

Work phone:

Cell phone:

Email address:

Availability

Please indicate the days and times you are available to volunteer.

Emergency Contact

Please enter a person we may contact in case of an emergency.

First name:

Last name:

Title:

Preferred phone:

Relationship:

Education

Select the option that most closely matches your highest level of education completed.

Education:

Most Recent Educational Institution:

Other Educational Institution:

Employment

Please list your current employer and one previous employer.

1

2

Employer name:

Contact Name:

Street 1:

Street 2:

City:

State:

Zip:

Position Held:

Preferred phone:

Email address:

Position Start Date:

Position End Date:

Area of Interest

Choose all that apply.

* Interest:

References

Please provide a professional, personal or academic reference.

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2

First name:

Last name:

Street 1:

Street 2:

City:

State:

Zip:

Preferred phone:

Email address:

Relationship:

Why would you like to volunteer with us?

How did you hear about us?

Felony Conviction?

Have you ever been convicted of a felony, excluding traffic violations?

If convicted of a felony, please explain the situation:

Demographic Information

The eligibility of applicants to volunteer with The Five Pearls Foundation is determined without regard to gender, disability, age, race, skin color, religion, sexual orientation, marital status or other condition. In no way will this information be used to determine your eligibility to volunteer. The information you provide, will be used to ensure that the volunteers reflect the community we serve. We will also use the inforamation when we work to secure funding for our volunteer programs.

Date of birth:

Gender:

Ethnicity:

Personal Income:

EMail Preferences

We like to keep volunteers informed of important news, schedules, and volunteer opportunities by email, however will not send you any email you prefer not to receive. Use the checkboxes below to select the kinds of email you would like to receive from us.

What kinds of email would you like to receive?

Electronic newsletters

Recruitment appeals

Schedule reminders

I Agree

I hereby consent to permit The Five Pearls Foundation to contact anyone it deems appropriate to investigate or verify any information provided by me to discuss my suitability for a volunteer position, including my background, volunteer experience, education or related matters. I expressly give my consent to any discussion regarding the foregoing and I voluntarily and knowingly waive all my rights to bring an action for defamation, invasion of privacy, or similar cause of action, against anyone providing such information.

I further authorize The Five Pearls Foundation and any organization affiliated with the Five Pearls Foundation to investigate my background as necessary and for these affiliated organizations, including but not limited to, law enforcement agencies, to provide reports to The Five Pearls Foundation concerning my background for the consideration of my application for a volunteer position. I also consent to permit The Five Pearls Foundation to obtain information pertaining to any charges/convictions I may have had for federal and state criminal law violations.

I certify that all of the information I provided is true and accurate, to the best of my knowledge and belief, and subject to verification by The Five Pearls Foundation, which is under no obligation to assign me as a volunteer. I understand that any omission or misrepresentation of fact in this application may result in refusal of or separation from volunteer service upon discovery thereof.

Photo Consent Release: I give my consent to The Five Pearls Foundation’s use of photographs or videotapes of me while participating in volunteer activities. These photographs or videotapes may be published in newsletters, web site or brochures, or use in news broadcasts for The Five Pearls Foundation.

I understand and agree that submitting this application form does not automatically register me as a Five Pearls Foundation volunteer, and that there may be certain qualifications I must meet, including the acceptance of established volunteer policies and procedures before I may begin volunteering.

By submitting this form, I attest that the information I have provided on the form is true and accurate.

I Agree