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BOOK CLUB - VOLUNTEER FACILITATOR APPLICATION AND BACKGROUND CHECK AUTHORIZATION FORM
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* Indicates required question
Email
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Your email
First Name
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Your answer
Last Name
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Your answer
Street Address
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Your answer
City
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Your answer
State
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Your answer
Zipcode
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Your answer
Cell Phone Number
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Your answer
Email Address
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Your answer
Social Security #
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Your answer
Driver's License # and State Issued
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Your answer
Employer and Job Title
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Your answer
Do you have experience working with people with disabilities? If Yes, please describe.
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Yes
No
When are you available to begin serving as an NCBC Volunteer Facilitator?
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Your answer
What days of the week are you available to volunteer? Check any days you are available each week. Your club will meet one day each week.
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Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Required
Have you ever been convicted of a misdemeanor or felony? (If you are convicted of a misdemeanor or felony, you need to inform Texas Advocates within 24 hours)
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Yes
No
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