Appalachian Children’s Emergency Shelter
                                                                                                                       Volunteer Program

                                                                                                             VOLUNTEER APPLICATION

Name _____________________________________ Phone _________________________
Address ________________________________________________________________
Email: ____________________________________Cell Phone______________________
Top of Form
Social Security # _____________ Date of Birth __________ Gender Male Female
Bottom of Form
Please answer the following questions:
Why are you interested in volunteering for ACES-Pickens? ________________________________________________________________________
________________________________________________________________________
Do you have any previous volunteer experience? If so, where and doing what? _____
_____________________________________________________________________
Are you presently volunteering in other organizations? If so, which and how often? ________________________________________________________________________
What kinds of skills or expertise can you offer? ____________________________________
__________________________________________________________________________
Which hours are you available to volunteer? ____________ A. M. ________________ P. M.
How many hours per week are you available? Which days or nights? __________________
_________________________________________________________________________
What do you expect us to do for you so that your experience turns out to be satisfying?_________________________________________________________________
_________________________________________________________________________

All individuals who have direct contact with the children in the shelter, whether paid or volunteer, must have a criminal background & fingerprint check through Georgia Applicant Processing Services ($31.15 fee). Are you willing to do these? __________
Also, all individuals will be required to complete CPR, First Aid certification, and an all day training/ orientation held by ACES staff.
List the names, relationship to you and contact numbers for three (3) character references.
1. _____________________________________________________________________
2. ______________________________________________________________________
3. ________________________________________________________________________

THANK YOU FOR INTEREST IN VOLUNTEERING TO HELP THE CHILDREN.

FOR ACES USE ONLY:
Date Application Received by ACES:___________________________________________

Reviewed by Board Development Committee on:________________________________

Results of Review:________________________________________________________

Applicant Contacted by:_____________________Date:_______________________________

AUTHORIZATION FORM

Please read this carefully before signing.

Please initial each of the following indicating your agreement:

____ I agree to follow all Volunteer Program guidelines and understand that any violation will result in suspension and/or termination of the volunteering relationship.

____ I understand that ACES Volunteer Program is not obligated to provide a reason for their decision in accepting or denying me as a volunteer.

____ I authorize ACES to obtain any needed information regarding my driving record, legal/criminal history, character references, and employment from any state or federal agency, my employer, and personal references for the purposes of participating in a Volunteer Program.

____ (Optional) I agree to allow ACES Volunteer Program to use any photographic image taken of me while participating in the volunteer program. These images may be used in promotions or other related marketing materials.

I understand I must return all of the following COMPLETED items along with this application. Any incomplete information will result in the delay of my application being processed:
· Copy of valid driver’s license
· Confidentiality Form
· Job Description Form
· Personal References
· MVR Release Form
· Criminal History Release Form

* Category 2 Volunteers only require Volunteer Application (if visit exceeds 24 hours) and Confidentiality Form*

By signing below, I attest to the truthfulness of all information on this application and agree to all the above terms and conditions.

_____________________________________________ __________________
Signature Date

Please email completed application to communityrelations@acespickens.org or mail to ACES, PO BOX 786, Jasper, GA 30143.

Thank you for your interest in becoming a volunteer with ACES!