*Are you over 18?
*Birth Date (day/month):
*Please indicate your availability (Check all that apply):
*Which volunteer activities are of particular interest to you (Check all that apply):
Are you willing to act as a translator?
Please list two people who have known you for several years.
Please do not use family as a reference.
*Have you ever been convicted of a felony and/or misdemeanor in this State or any other jurisdiction?

Nature of Conviction, State of Conviction, Date of Arrest, Date of Conviction, Sentence/Disposition, and Date Sentence Completed

Registrants for volunteer work are required to disclose all felony/misdemeanor convictions in this State or any other jurisdiction. Prior convictions will not necessarily bar him/her from volunteering. Prior convictions are reviewed on a case-by-case basis. Individuals will only be denied an assignment based on the conviction if it is related to the proposed position. All information regarding conviction records will be kept confidential and will not be disclosed outside of BRC.

I affirm that the information I have provided on this Volunteer Registration Form is true and correct to the best of my knowledge. I agree to conform to the BRC rules and regulations to the best of my ability. I agree to respect the confidential nature of case information as well as my personal contacts with the clients. At the time I choose to discontinue my active volunteer status, I agree to notify my direct supervisor, to return my Volunteer ID badge, and to complete an exit interview if requested.