Volunteer Application – Building Bridges

Name *

First

Last

Phone *

Email *

Address

Address Line 1

Address Line 2

City

State

Zip Code

How did you find out about our organization?

List memberships in clubs and organizations

List hobbies and skills (from crafts to technical)

Reasons for Volunteering with BBHIH

Checkmark the activities you are interested in participating in (*can be done at home)

How many hours per week would you be able to dedicate?

What days of the week are you available?

What time of day are you available?

Morning
Afternoon
Evening

Do you have any criminal convictions, including charges involving domestic violence and/or minors? *

Yes
No

Please Describe

Will you be willing to having a nationwide background check processed, if needed?*

Yes
No

Please explain

How many years have you been a Missouri resident?*

In Case Of Emergency

Contact In Case Of Emergency

Emergency Contact Name *

First

Last

Emergency Contact Phone

Emergency Contact Relationship

/ Reasons Phone

Physician

Physician Name *

First

Last

Physician Office / Clinic

Physician Phone

Before hitting the “Submit” button below, verify the information given on this application is accurate to the best of your knowledge. By submitting, you also agree to the policies listed below. (Please, be sure to look back over the application before submitting.)

As a volunteer/mentor, you will not be alone with a client at any time
Any contact with clients outside of BBHIH events/programs is only liable to the individual volunteer/mentor
When representing BBHIH (at events, mentoring youth, wearing BBHIH shirts, etc.), respect others, yourself, us, and property
BBHIH has the right to request volunteers to take a drug test
BBHIH is not liable for any injuries that take place during an event or mentoring
You consent to have your photo taken at BBHIH events.