Jesters Volunteer Application

 

Online Registration

Today's Date* (Format: mm/dd/yyyy)
First Name*
Middle Initial*
Last Name*
Preferred Name
Date of Birth* (Format: mm/dd/yyyy)
Social Security Number (required to do background check)
Driver's License Number*
DL State*
Home Address*
City*
Zip*
Home Phone
Cell Phone
Email Address*

Jester Volunteer Opportunities - Tell us where you are interested in volunteering:
 
Rehearsal Volunteers – weekly is ideal, twice a month minimum
 
Food or Party Volunteers – provide food supplies or venue
 
Production Volunteers – intermittent help throughout the Fall, consistent help
 
Day of Show Volunteers – February 11th and 12th
 
Miscellaneous – Getting the word out about the show
 
Are you a HPUMC Member?*

If yes, for how long?
If not, current or previous religious affiliation
Place of employment*
Occupation or position*
Work Phone*
How would you prefer to be contacted?*
How did you hear about the JESTERS program?*
Education, special training or previous volunteer experience*
Health limitations or special considerations*
List any experience you have working with people with special needs*
Do you have any theater experience?*
Licenses, permits or certifications?*
CPR Certified?*

If yes, Date Certified
Activities of interest at JESTERS (check as many as apply)






 
I am comfortable being paired with a person who has

 
Fluent in other languages?


 
Tshirt Size*

Legal History
Are you free of illegal substance abuse? *

 
Have you ever been convicted of a criminal offense?*

 
Have you ever been arrested or convicted for the use or sale of drugs?*

 
Have you ever been treated for alcohol or substance abuse?*

 
Have you ever been arrested or convicted of child neglect, abuse, or any form of sexual misconduct? *

 
Has your driver’s license ever been suspended or revoked?*

Other than the above matters, is there any fact or circumstance involving you or your background that would call into question your being entrusted with the supervision, guidance, and care of people with special needs? *
 

FOR ANY “YES” ANSWERS, NUMBERS 2-7, PLEASE PREPARE A DETAILED EXPLANATION. THANK YOU

We are required to run a criminal background check on all volunteers. Upon completion of this volunteer application form you will be given a copy of our Protection Policy and a form to fill out for the background check.

Personal References:  Please list ALL information for your references.  Please include a
co-worker, friend, and employer/supervisor.
Name, address, phone number and relationship for all references:

 

Reference 1*
Reference 2*
Reference 3*
Emergency Contact Name*
Emergency Contact Phone*
Signature*
To prevent spam, please tell us:
What is seven added to five?*