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SOAR (Student Options to Achieve Results)
PAL APPLICATION FORM
www.palkids.org
Please check any/all that are applicable:
___Regular Volunteer ___ Community Services Hours Requested
___Internship/College Credit Requested ___ Interested in SOAR Leadership Team
___High School Credit Requested
NAME:
(Last) (First) (Middle)
MAIDEN NAME/OTHER NAMES USED:
DATE OF BIRTH:______/_____/_____ SS#________-________-_________ RACE:
HOME ADDRESS:
CITY____________________________________________ STATE__________________________ ZIP
PHONE: PHONE:
(Day) (Evening)
MESSAGE/CELL/PAGER: E-MAIL:
DRIVERS LICENSE #_________________________________ STATE____________ BPST#(for officers)
LIST ALL STATES YOU HAVE RESIDED IN OVER THE PAST FIVE YEARS:
OCCUPATION:
EMPLOYER:_____________________________________________________________WORK#:
EMERGENCY CONTACT:________________________________________________ PHONE#:
WHAT ARE THE BEST DAYS/TIMES FOR YOU TO VOLUNTEER?
WHAT TYPE OF WORK ARE YOU INTERESTED IN DOING WITH SOAR?
ð Arts & Crafts ð Physical Education ð Educational Classes
ð Chaperoning Field Trips ð Recreational Classes ð Fundraising
ð Other:
HAVE YOU DONE LOCAL VOLUNTEER WORK BEFORE?
IF YES, FOR WHAT ORGANIZATION(S)
HOW DID YOU HEAR ABOUT SOAR?
WHY ARE YOU INTERESTED IN VOLUNTEERING WITH SOAR?
Please complete the reverse side of this form
PLEASE LIST NON-RELATED REFERENCES:
NAME |
DAYTIME PHONE |
MAILING ADDRESS |
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EDUCATIONAL BACKGROUND:
SCHOOL NAME |
DATES ATTENDED |
HIGHEST GRADE COMPLETED |
DEGREE EARNED |
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SPECIAL SKILLS:
Computers: Arts & Crafts Foreign Language:
- Coaching the following sports:
- Special Driver’s License: Other:
Read the following carefully before you sign:
- Due to the nature of the work involved with SOAR, all prospective employees and volunteers will be subject to a criminal history check. This check is confidential and open to explanations. By signing on the line below, you are both authorizing this background check and confirming that all information listed above are valid and truthful to the best of your knowledge.
- A false statement on any part of your application will be grounds for not selecting you, or for removing you from the SOAR staff after you have been selected.
- I consent to the release of information about my ability and fitness for service as a SOAR staff member by my workplace, schools, law enforcement agencies, and other individuals and organizations, to investigators, personnel staffing specialists, and other authorized employees of SOAR.
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Signature Date
Please return to:
SOAR
c/o Molalla Police Activities League
PO Box 726
Molalla, OR 97038
Fax: 503-829-2614
For office use only:
____________________ Date Received _____________________ Background Check Complete
____________________ Orientation Notice Sent ________________ First Volunteer Activity Completed
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