Form Test

Address *

Line 1

Line 2

City

State

Zip Code

Country

Birthdate *

Phone Number *

Other Phone Number *

May we use texting to contact you *

Yes No

Volunteer Experience

Please indicate what hours you would be available on those days. *

Criminal History

Have you ever been charged, convicted of, or pled guilty to a crime, either a misdemeanor or a felony (including but not limited to drug-related charges, child abuse, other crimes of violence, theft or motor vehicle violations? Choose One *

Yes No

Personal References

Background Check Authorization

To protect the families and children we work with, Mobile Hope requires background checks to be performed on all regular volunteers. Please affirm your agreement to the statement below. After which you will receive a link via email where you can submit your information.

"I hereby authorize Mobile Hope to obtain and/or request information about my criminal history from any entity chosen specifically for conducting this search, to release information regarding any record of charges or convictions contained in its files, or in any criminal file maintained on me, whether said file is a local, state, or national file, and including but not limited to accusations and convictions for crimes committed against minors, to the fullest extent permitted by city, county, state, and federal law. I do release said entities from all liability that may result from any such disclosure made in response to this request. I may revoke this request at any time, but that revocation must be in writing and give 30 days' notice of the same."

Background Check Fee

You may still submit your application if you are unable to cover this cost. It will then be covered by Mobile Hope."

Applicant Statement

Please read and sign below.
I certify that this volunteer application was completed by me and that all of the information on this application is true and correct to the best of my knowledge. I understand that any falsification, misrepresentation, or omission of facts called for herein will result in my disqualification from further consideration as a volunteer. I understand that this volunteer application is not valid without my signature.