Students:

Please provide a copy of your most recent report card and if under 16 a parent permission letter.

References:

Please provide the name,address, and phone/e-mail of three non–family members that you have known for at least three years who can give references on your behalf.

Confidentiality Agreement

As a volunteer, I understand that I may meet residents and individuals served by The Good shepherd Alliance (GSA) and may be privy to their personal information. Federal law requires the confidentiality of all current and former residents, as well as any applicant for services.

• I understand The Good Shepherd Alliance has granted me the opportunity to volunteer my time is not liable for my safety while I volunteer.
• I understand disclosing any information about residents is prohibited.
• I understand photography of residents is prohibited.
• I understand any violation of the guidelines outlined in the Volunteer Handbook could result in my termination as a volunteer.
• I understand my role as a volunteer is to support GSA as the organization serves families in need and the community.
• I understand my role is to do only the volunteer tasks assigned to me and not to provide any other service or resource, financial or otherwise, unless approved in writing by GSA.
• I understand I am not to solicit information about GSA residents, housing, or operations.
• I understand GSA has permission to photograph all volunteers performing volunteer duties.

Authorization and Consent to Conduct Background Check

In connection with my application to volunteer with The Good Shepherd Alliance,(GSA), I hereby give my consent and authorize GSA, and its representative(s) to employ the Virginia State Police and Federal Bureau of Investigation to search any available files for a criminal history record and report results to the agent or individual authorized in this document.