Emergency Contact Information
|Primary Contact Name: *|
|Primary Contact Home Phone: *|
|Primary Contact Mobile Phone: *|
|Primary Contact Work Phone: *|
|Secondary Contact Name: *|
|Secondary Contact Home Phone: *|
|Secondary Contact Mobile Phone: *|
|Secondary Contact Work Phone:|
|What day(s) are you available for volunteering?|
|Which area(s) are you interested in volunteering?|
|List other volunteer area(s) you are interested in not listed above:|
Consent - Photographic Release
I hereby authorize The Dream Center of Pickens County to release any photographs
taken of me for any purpose related to the promotion and well-being of
The Dream Center of Pickens County including,but not limited to
newspapers, magazines, presentations and television.
|I Consent: *|
Consent - Disclaimer and Signature
By electronically submitting this application I affirm, agree, and understand that all statements on this volunteer application are true and accurate.
I also grant permission to the The Dream Center of Pickens County to check with appropriate authorities upon matters of record regarding my background or history.
I understand The Dream Center of Pickens County is a faith based non-profit organization operating with Christian beliefs and values.