Your Name *

First Name

Last Name

Clearance *

By checking the box below, I acknowledge that Homefields will complete background check(s), including a PA criminal background check. Homefields will inform me if a child clearance is needed. Background checks will be completed at no cost to me. Clearances are confidential and maintained in a locked filing cabinet. A criminal record does not automatically exclude individuals for consideration for volunteer roles with Homefields. My signature below indicates permission for Homefields to contact individuals who are listed as references and relieves Homefields from liability pertaining to the content of reference checks. Volunteers will be required to present two forms of valid I.D., one must be a photo I.D.

I agree

Residency *

At the time of this application, I affirm that I have lived in Pennsylvania for more than two years.

At the time of this application I affirm that I have been living outside of Pennsylvania for two or more years.

Phone

(###)

###

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Name *

First Name

Last Name