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(317) 890-9817

DRIVEN 2 SUCCESS

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Volunteer

Application Form

Pathway to the Future Learning Center, Inc. D/B/A Pathway Resource Center, Inc. (Pathway) is an equal opportunity organization Applicants are considered for employment without regard to race, color, national origin, religion, sex, age, handicap, disability, citizenship status, or any other basis prohibited by law, unless such basis constitutes a bona fide occupational qualification. Pathway to the Future Learning Center, Inc. will comply with its legal obligation to provide reasonable accommodations to qualified individuals with disabilities. We are committed to fostering, cultivating and preserving an ethical workplace with a culture of diversity, equity and inclusion.

Full Name

Today's Date

Current Address

If you have resided at your present address less than three years, list your prior address:

Previous Address

Email

Phone Number

Which days are you available?:

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

How many hours a month are you able to volunteer?

How many hours a week are you able to volunteer?

First date available to volunteer:

Have you volunteered or completed an application here before?

Yes

No

If yes, give date:

Have you ever been employed by Pathway?

Yes

No

If yes, please list the date(s) and position.

Do you have any relatives employed by Pathway?

Yes

No

If yes, please list your relatives’ name(s).

Did anyone refer you to this volunteer opportunity? If so, whom?

Are you 18 years of age or older?

Yes

No

Date of Birth

Emergency Contact Name

Emergency Contact Address

Emergency Contact Number

Summarize special interest or skills, community service and qualifications acquired from education, employment, volunteer work, or military service.

List specific skills or technology, tools, machinery or other equipment that you are trained on and can operate that will be helpful in performing the responsibilities of the position(s) for which you are applying.

What areas are you interested in volunteering? Areas include: Youth, training and workshops, community events, field trip chaperones:

Why are you interested in volunteering with us?

What are your passions?

List the name, address and telephone number of three references.

Reference #1

Full Name

Email

Phone Number

Reference #2

Full Name

Email

Phone Number

Reference #3

Full Name

Email

Phone Number

Signature of Applicant:

Date

I certify that this application was completed by me and that all entries on it and all information is TRUE and COMPLETE to the best of my knowledge. In the event of being selected as a volunteer I understand that false, misleading, or omitted information on my application may result in discharge.

I authorize verification of all statements contained in this volunteer application as may be necessary in arriving at the decision to engage me as a volunteer. In making this application, I understand that verifications may be made and information may be obtained through interviews with the personal references listed. This inquiry may include information as to my character, general reputation, and personal characteristics, as well as information about my performance and conduct. I consent to this verification and to the consideration of any statement of references that are given in response to the inquiry.

I hereby release all parties, including but not limited to Pathway and personal references from any and all liability for any injury or damage that may result from their furnishing information to Pathway, concerning me or any action Pathway.

I understand that if I am offered an opportunity to volunteer, as a condition of beginning my volunteer engagement that I may be required to undergo a physical examination and/or drug screen and I hereby authorize any doctor, hospital, clinic, laboratory or other medical facility to furnish any medical information with reference to me as may be necessary in conjunction with that examination and related consideration.

I understand this application is not, and is not intended to be, a contract of employment and that any resulting employment relationship is for no fixed period of time and is terminable at any time and for any reason by Pathway or by me. I further understand that statements which may be contained in policies, practices, handbooks, or other Pathway material do not create any guarantee of employment and Pathway has the right to modify, amend, or terminate policies, practices, benefits plans, or other programs within the limits and requirements imposed by law. I understand no representative of Pathway, other than an officer, has the authority to enter into any agreement for any specific period of time or to make any agreement contrary to the foregoing and any such agreement must be in writing to be binding by Pathway Resource Center, Inc.

Authorization to Conduct Criminal Background Inquiry: I hereby authorize Pathway to the Future Learning Center, Inc. D/B/A Pathway Resource Center, Inc. (Pathway), or an agent thereof, to conduct a criminal background check as a part of my volunteer application with Pathway. I further understand and agree that Pathway may refuse or terminate my engagement with the company in the event the criminal background check discloses a criminal history that, in the sole discretion of the Company, would suggest that I am not suited for the position for which I have made application.

Signature of Applicant:

Date

Thank you!

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10119 John Marshall Drive Indianapolis, IN 46235

(317) 890-9817

info@pathwayindy.org

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ABOUT
PROGRAMS
SERVICES
NEWS & EVENTS
GET INVOLVED
JOBS
IMPACT
- 2024
- 2023
- 2022
- 2021
CONTACT

Hours of Operation

Monday - Thursday
10:00am - 5:00pm

12pm-1pm (closed for lunch)
Or on an appointment basis.

Closed to public on Fridays

© 2023 Pathway Resource Center. All Rights Reserved.

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