2024 Hope Prom Volunteer Registration

Name

Age

Address

This address will receive a confirmation email

*** Email will be our primary method of communcation during the planning process.

Phone

T-Shirt Size (Unisex)

Parent Name (If Under 18)

Parent Phone (If Under 18)

Emergency Contact During Event

Emergency Contact Phone

Backround Checks Are REQUIRED For ALL Volunteers Over The Age Of 18.

Have you had a background check at Hope Church since October 2022?

Yes No

Date Of Last Background Check (MM/YY)

If background check is not current, please fill in the blank with the last 4 digits of your Social Security number so we can run a background check for you. If you already have one, type N/A.

*** If you have completed a background check through your employer since October 2022, please have your Human Resources Personnel fax it to Hope Church re: Ginger Southard at (434) 836-5092.

Former/Current Experience Or Training With People With Disabilities (Check All That Apply)

Healthcare Professional (i.e. speech-language pathologist, occupational therapist, behavior technician, creative arts therapist, etc.) Special Education Teacher Fluent In American Sign Language (ASL) Other Direct Service Provider No Experience Other

If Other, please explain:

*** Please not that experience is not necessary to be a volunteer.

I have volunteered previously with Night To Shine or Hope Prom.

Yes No

*** The Hope Prom Planning Team will make every effort to place you in your desired team, but it cannot be guaranteed. Individuals who have completed their background checks will be placed in teams first.

Are You Willing To Be An Alternate Buddy, Should The Need Arise During The Event?

Yes No

Will you be volunteering with a friend or family member?

Yes No

If so, list their name and relationship to you.

If you are a volunteer between the age of 14-17, please have your parent or legal guardian complete the following:

I give permission for my child to participate as a volunteer at the 2024 Hope Prom at Hope Church in Danville, VA on October 5th, 2024. Intitial:

2024 Hope Prom Volunteer Registration

Description

Please Fix the Following