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It captures current and previous employment details, optional supervision or youth transport requirements, and driver’s license and insurance information. The form records education, volunteer experience across agencies, interest in volunteering, and required history questions. 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The applicant authorizes reference inquiries regarding previous/present volunteer and work experience and confirms that false or withheld information may disqualify them.","https://schema.org",{"og:url":78,"og:type":120,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":122,"canonical":78},"index,follow",{"doc_id":124,"site_id":56},256792,1789307497,{"code":4,"msg":5,"data":127},{"doc_id":124,"user_id":128,"nickname":88,"user_avatar":129,"doc_module":9,"category_id":35,"category_name":36,"doc_title":59,"doc_description":61,"doc_content":130,"file_id":131,"file_url":132,"file_type":133,"file_size":134,"view_count":8,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":79,"language":135,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":136,"faqs":137,"seo_title":138,"seo_description":61,"update_tm":125,"read_time":73},1374391974585,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","NC Department of Public Safety Program Volunteer Application Template  \n\n| Volunteer Application Date: |  |  |  |\n| --- | --- | --- | --- |\n| Volunteer Interest:\u003Cbr>(Check all that apply) |  |  | Mentoring  Individual\u003Cbr>Group  Agency |\n|  | |  |  |\n\nCONTACT INFORMATION  \n\n| Full Name: |  |  | Home Phone: | ( ) |  |\n| --- | --- | --- | --- | --- | --- |\n| Current Address: |  |  | Cell Phone: | ( ) |  |\n|  |  |  | E-mail Address: |  |  |\n|  |  |  |  |  |  |\n| How long have you lived at the above address?   years   months |  |  |  |  |  |\n| List previous address if you have lived at the current address less than two (2) years |  |  |  |  |  |\n| Street Address: |  |  |  |  |  |\n| City: |  | State: |  | Zip: |  |\n\n\n| Family Status: |  |  | Single |  | Married |  |  |  |  |\n| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |\n| Emergency Contact Name:(If applicable) |  |  |  |  |  | Emergency\u003Cbr>Contact \\#: | ( ) | Relationship: |  |\n\nEMPLOYMENT INFORMATION (Current)  \n\n| Employer: |  | Your Title: |  |\n| --- | --- | --- | --- |\n| Address: |  |  |  |\n| Contact \\#: | ( ) |  |  |\n\nEMPLOYMENT INFORMATION (Previous)  \n(List previous employer if at current employment less than two (2) years.)  \n\n| Employer: |  | Your Title: |  |\n| --- | --- | --- | --- |\n| Address: |  |  |  |\n| Contact \\#: | ( ) |  |  |\n\nTHIS SECTION IS REQUIRED IF YOU WILL SUPERVISE OR TRANSPORT YOUTH.  \n\n| SS \\#: | - - |  |  | Date ofBirth: |  |  |  |  |  |\n| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |\n| Do you have a valid driver’s license? |  |  | No |  |  | Yes |  |  |  |\n| Driver’s License \\#: |  |  |  | State Issued: |  |  |  | Expiration Date: |  |\n| Auto Insurance Carrier: |  |  |  | Insurance\u003Cbr>Expiration Date: |  |  |  |  |  |\n\nEDUCATION INFORMATION  \nForm JCPC/EA 001 Program Volunteer Application Template  \nForm structure last revised July 2014  \nNC Department of Public Safety Page 1 of 4  \nProgram Volunteer Application (cont'd)  \n\n| School(s)\u003Cbr>Attended: |  | Degree Received: |  |\n| --- | --- | --- | --- |\n|  |  | Degree Received: |  |\n|  |  | Degree Received: |  |\n\nVOLUNTEER EXPERIENCE  \n\n| Agency\u003Cbr>Name: |  |  |  |  | Dates of volunteer work: |  |\n| --- | --- | --- | --- | --- | --- | --- |\n| Contact Name: | ( ) |  |  |  | Contact \\#: | ( ) |\n| Did you work directly with youth when volunteering at this agency? |  | No |  | Yes If yes, briefly describe. |  |  |\n|  |  |  |  |  |  |  |\n| Describe other volunteer responsibilities and reason for leaving, if applicable: |  |  |  |  |  |  |\n\n\n| Agency\u003Cbr>Name: |  |  |  |  | Dates of volunteer work: |  |\n| --- | --- | --- | --- | --- | --- | --- |\n| Contact Name: | ( ) |  |  |  | Contact \\#: | ( ) |\n| Did you work directly with youth when volunteering at this agency? |  | No |  | Yes If yes, briefly describe. |  |  |\n|  |  |  |  |  |  |  |\n| Describe other volunteer responsibilities and reason for leaving, if applicable: |  |  |  |  |  |  |\n\n\n| Agency\u003Cbr>Name: |  |  |  |  | Dates of volunteer work: |  |\n| --- | --- | --- | --- | --- | --- | --- |\n| Contact Name: | ( ) |  |  |  | Contact \\#: | ( ) |\n| Did you work directly with youth when volunteering at this agency? |  | No |  | Yes If yes, briefly describe. |  |  |\n|  |  |  |  |  |  |  |\n| Describe other volunteer responsibilities and reason for leaving, if applicable: |  |  |  |  |  |  |\n\nForm JCPC/EA 001 Program Volunteer Application Template Form structure last revised July 2014  \nNC Department of Public Safety Page 2 of 4  \nProgram Volunteer Application (cont'd)  \nCURRENT VOLUNTEER INTEREST  \nWhy are you interested in volunteering with this agency?  \nHISTORY INFORMATION  \n\n| Do you have any history of alcohol or drug abuse? |  |  | No |  | Yes |\n| --- | --- | --- | --- | --- | --- |\n| If yes, briefly explain including any treatment received. |  |  |  |  |  |\n\n\n| Have you ever been convicted of a misdemeanor or felony? |  No  Yes |\n| --- | --- |\n| If yes, briefly explain including offense and conviction dates. |  |\n\n\n| Have you eve","cbCaieSOgmYq7NNY","https://ap.wps.com/l/cbCaieSOgmYq7NNY","pdf",160235,"English","# Volunteer Interest\n# Contact Information\n# Employment Information (Current)\n# Employment Information (Previous)\n# Driver’s License and Youth Supervision/Transport Section\n# Education Information\n# Volunteer Experience\n# Current Volunteer Interest\n# History Information\n# References\n# Certification and Authorization\n# Agency Use Only","[{\"question\":\"What personal and contact details are required to complete the application?\",\"answer\":\"The form requests full name, home and cell phone numbers, email address, current address, how long the applicant has lived at that address, and prior addresses if the current residence is under two years.\"},{\"question\":\"What information is needed if the volunteer may supervise or transport youth?\",\"answer\":\"The template requires SSN, date of birth, a driver’s license status and number, issuing state, expiration date, and auto insurance carrier and expiration date.\"},{\"question\":\"What checks and authorizations does the volunteer certify?\",\"answer\":\"The applicant agrees to a criminal background check and, when supervising or transporting youth, a driver’s license check. The applicant authorizes reference inquiries regarding previous/present volunteer and work experience and confirms that false or withheld information may disqualify them.\"}]","NC Department of Public Safety Program Volunteer Application Template | PDF"]