LAUP Volunteer Form 
Please ensure that all fields are filled out accurately and submit your form. 
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Name  *
Phone number  *
Email Address  *
Area(s) of Interest  *
Required
How did you hear about us?  *
Required
Do you have any limitations that require accommodations?  *
Emergency Contact 
Name  *
Relationship  *
Phone number  *
Email Address  *
AVAILABILTY 
Mornings 8:30am - Noon  *
Required
Afternoon Noon-6:00pm  *
Required
Evenings 6:00pm - Later  *
Required
Please list any specific dates (mm/dd/yy) that will not work for you:
How often do you plan on volunteering through this year?  *

Notification and Authorization to Release Criminal Background Information-Volunteers

Notification

Latin Americans United for Progress requires me to consent to a criminal background check as a condition of volunteering. This check includes the following:

  • Criminal history reference searches for felony and misdemeanor convictions at the country, state, and federal levels in every jurisdiction where I currently reside or have resided during the past 7 years.

  • Sex offender’s registry searches at the country, state, and federal levels in every jurisdiction where I currently reside or have resided.

Authorization
I hereby authorize Latin Americans United for Progress (LAUP) to conduct the criminal background check described above.
Please type FULL LEGAL NAME ( for identification purposes):  *
Other names you have used in the past seven years:
Current Address *
Previous Address (most recent) *
Phone number  *
Alternate phone number
Date of Birth *
MM
/
DD
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Gender *
Race *
Required
Social Security Number *
Driver's License # *
State of Drivers License  *

Have you ever been convicted of a criminal (offense or have any pending criminal) charges against you? 

*This refers only to felonies and misdemeanors; you do not need to include non-criminal traffic violations or municipal ordinance violations.


 *
If yes , please provide detail below *

To the best of my knowledge, the information provided in this Notice and Authorization and any attachments thereto is true and complete. I understand that any falsification or omission of information may disqualify me to volunteer at LAUP.

By signing below, I hereby provide my authorization to LAUP to conduct a criminal background check. I understand that I have a right to appeal an advertising decision made by LAUP based on my background check information within three business days of receipt of such notice and that a determination on my appeal will be made in seven working days from LAUP’s receipt of such appeal.


Electronic Signature  *
Date *
MM
/
DD
/
YYYY
Receipt & Acknowledgement
By clicking yes to the fields below, I acknowledge receipt and understanding of the following documents
 *
Yes - Volunteer Guidelines
Yes - Confidentiality Policy
Volunteer Guideline
Confidentiality Policy

By signing below:

I agree to follow the Volunteer Guidelines.

I am willing to protect the confidentiality of all individuals who have requested or are receiving services

I agree that I will not disclose or discuss information regarding any client to any unauthorized person or organization.

I have read and agree to follow the Latin Americans United for Progress Confidentiality Policy.

Electronic Signature  *
Date *
MM
/
DD
/
YYYY
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