Community Service Application

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Application to perform community service at EVE (End Violent Encounters)

Date *

YYYY

Full Name *

Address *

Cell Phone *

Email *

Are you 18 or older? *

Yes

What is your availability? *

How many hours do you need to complete? By what date? *

What is the name of your probation officer? *

Are you currently receiving services from EVE? *

Yes

Have you received services from EVE in the past? *

Yes

Do you take any medication that could affect your work? *

Yes

Do you have any special needs that require accommodations? *

Yes

If yes, please explain the accommodation or type N/A: *

Have you had any previous volunteer experiences? *

Yes

If yes, where did you volunteer? Describe responsibilities or type N/A: *

EVE is sensitive to the fact that some individuals are victimized by the legal system. Answering yes to the following question will not automatically disqualify you as a potential volunteer.

Have you ever been convicted of a felony, or do you have charges pending? If so, please describe or type N/A: *

DUE TO THE NATURE OF OUR WORK AND FOR THE SAFETY OF STAFF, CLIENTS AND VOLUNTEERS, A CRIMINAL BACKGROUND CHECK MUST BE COMPLETED. Please answer the following:

Consent to run background check.

Previous Last Name(s) if applicable: (If none, type "none" in answer box.) *

Date of Birth *

YYYY

Sex *

Male

Female

Other:

By typing your name below you hereby authorize EVE to obtain information pertaining to any charges and/or convictions you may have had for federal and state criminal violations. *

By typing your name below you agree that if you have lived or resided outside the State of Michigan during the past ten (10) years that you have never been convicted of a felony or identified as a perpetrator. *

By typing your name below you agree to provide EVE with information regarding any felony conviction you have received outside the State of Michigan. *

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