Volunteer Application

First name

Last name

Address

City

State

Zip Code

Email

Phone

Preferred Times to Volunteer

Morning

Afternoon

Evening

Flexible

Do you have prior experience working with children or individuals with autism?

Yes

No

If yes, please provide the details of your experience

What made you interested in volunteering with Divinity ABA?

What skills or talents can you bring to the team?

Background Check - Have you ever been convicted of a felony or misdemeanor?

Yes

No

(Note: A conviction will not necessarily disqualify you from volunteering.)

If yes, please explain

Do you have any medical conditions or allergies that we should be aware of while you are volunteering?

Yes

No

If yes, please describe

Are you comfortable working in environments where you may be required to assist children with specific needs or behaviors?

Yes

No

By entering my full name below, to be used as my signature, and submitting, I agree to the following:

I agree to uphold the values and mission of Divinity ABA while volunteering.
I understand that as a volunteer, I will be required to undergo a background check and additional training.
I confirm that the information provided in this application is truthful and accurate to the best of my knowledge.

Please type in your full name

Date

Month

Day

Year