Name *

First Name

Last Name

Cell Phone *

(###)

###

####

Work Phone

(###)

###

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Have you ever been convicted of a crime? *

If yes, explain below.

Yes

No

Please check which area(s) you feel that you would be able to best assist with: *

Painting

Sculpting

Crafts

Carpentry

GLBTQ

Business Skills

Marketing Skills

Board Service

Other - Please explain below.

Acceptance of Terms *

I have read this application and fully understand that upon submission, and periodically if accepted as a volunteer, my background history will be checked. I have not been influenced to any extent whatsoever by any representations or statements and I have not been promised anything. If accepted as a volunteer, I understand that either party may voluntarily or involuntarily terminate the relationship.

I agree with the above statement and authorize Project Success to submit my information for a background check through the FWPD.