First Name (required)

Middle Name

Last Name (required)

Maiden or Other Names You Have Used

Mobile Phone (required)

Home Phone

Email (required)

Street Address (required)

City (required)

State (required)

Zip Code (required)

Background Check Information
Information required for background check.

Date of Birth (required)

Driver License Number (required)

Race (required)

Gender (required)
MaleFemale

Emergency Contact (required)

Relationship (required)

Emergency Contact Phone (required)

The West Michigan Friendship Center requires a criminal background and Protective Services investigation for all volunteers who may have direct contact with guests and/or confidential information.

I authorize this investigation. I authorize the release of the results of these background checks to The West Michigan Friendship Center. I hereby release local, state, and national enforcement agencies from any liability resulting from such disclosure.

I understand that this is an application for a volunteer role, but not a guarantee of an opportunity. I hereby affirm that the information provided in this application is true and complete. I also agree that any false information, misrepresentation, or omission may disqualify me from further consideration for volunteering and may result in dismissal if discovered at a later date.

Your e-signature authorizes us to perform a search of state and federal databases. Please type your full name.

Signature (required)