Please provide a copy of your most recent report card and if under 16 a parent permission letter.
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.
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.
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.
20684 Ashburn Road Ashburn, VA 20147
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