American Red Cross, Valdosta Chapter Volunteer Registration
Full Name
Date of Birth Month
Address
City, State, Zip
Phone:
Email:
Are you licensed to drive a car?
Have you ever volunteered for Red Cross before?
If yes, Chapter Name:
As a Red Cross Volunteer, I am interested in the following:
Have you ever been convicted of a felony or misdemeanor?
If yes, please explain:
I have given that above information voluntarily, and certify that all statements and representations are true and correct. I authorize verification of all statements and screening investigations including but not limited to driver's license, criminal background and personal reference checks. I consent for any person, entity, or agency to disclose to the Red Cross all information it may have about me. I understand that this may include information about my character, general reputation, personal characteristics and other information and that a report may be made. Upon written request, information about the nature and scope of the investigation will be provided to me. I understand that I am not an employee and will not be paid for my services as a Red Cross volunteer. I agree to abide by the volunteer personnel policies and procedures of the chapter.
Your Name
Date
