Group Volunteer Application

Group Volunteer Application Web Form
  • Personal Information

  • Please note the following restrictions: Because of our privacy laws and confidential nature of what we do at Children’s Hope Alliance, volunteer contact with children is very limited. This is to protect not only the children, but our volunteers as well. We do not accept volunteers that have been court ordered to community service. We cannot allow anyone under 18 to interact with our children for safety and privacy reasons. You must be over 21 to be a mentor.
  • Availability

    On days selected above please indicate what hours you are available to volunteer below.
    If you Selected "Specific Date and Times" above, please provide the detailed dates and times below.
  • Areas of Interest

  • If you selected "Other" from the above choices, please explain below
  • Please indicate the number of volunteers over 18 in group.
  • Please indicate the number of volunteers under 18 in group.
  • Special Skills

  • If you selected "Other" from the above choices, please explain below
  • REFERENCES (List up to 3)

  • Please provide Name, Relationship, and Contact Number for your reference
  • Please provide Name, Relationship, and Contact Number for your reference
  • Please provide Name, Relationship, and Contact Number for your reference
  • Please provide the Name, Home Phone, and Cell Phone Number for the person to contact in case of an emergency.
  • Application Agreement Statement

  • For the safety and security of the children, families and staff of Children’s Hope Alliance, we understand and agree that our references will be checked, and prior to volunteering, we will be subject to a criminal background check and other appropriate screenings. By submitting this application, we affirm that the facts set forth in it are true and complete. We understand that if accepted as a volunteer group, any false statements, omissions, or other misrepresentations made by us on this application may result in our immediate dismissal.
  • Confidentiality Agreement Statement

  • We understand that Children’s Hope Alliance protects youth and staff by keeping all information completely confidential and secure. We also understand and agree that it is our responsibility to support the established measures that safeguard such confidential information. At no time will we disclose any youth or staff information without prior approved authorization. We understand that violation of this confidentiality agreement may result in civil penalties and may result in our immediate dismissal.
  • Media Release Agreement Statement

  • We give my permission to allow our name and/or photographs to be used by Children’s Hope Alliance for agency newsletters, public relations and fundraising purposes now or in the future.
  • Disclaimer for Volunteers Statement

  • I have no criminal convictions that would adversely affect my capacity and ability to provide care, safety and security for the children in residence. I have not abused or neglected a child. I have not had child protective services involvement that resulted in the removal of a child. I have not been a respondent in a juvenile court proceeding that resulted in the removal of a child. I have not abused, neglected or exploited a disabled adult. I have not been a domestic violence perpetrator.
  • Signing Confidentiality Agreement

  • Closer to the time of your project, each individual in your group will be asked to sign a Confidentiality Agreement. This agreement protects the children / families in our care and is also a HIPPA requirement.

    Each individual in your group will also be asked to sign a Disclaimer for Volunteers and fill out a medical history form. These documents certify that the individual has no criminal, social, or medical history that would adversely affect their capacity to work with children and adults. This is a North Carolina DSS requirement.
  • Discrimination Statement

  • It is the policy of Children’s Hope Alliance to provide equal opportunities without regard to race, color, religion, national origin, gender, sexual preference, age or disability. If you have any problems with sending your application, please contact volunteer@childrenshopealliance.org.
  • This field is for validation purposes and should be left unchanged.