Edgewood Community Support Center (ECSC) (aka The EPICENTER at Edgewood)

Personal Information

Employment

References

Please give three character references with whom you have had sufficient contact with over the past five years and who can answer questions about you.

Areas of Interest

Personal

Briefly describe your motivations for volunteering with the Edgewood Community Support Center (aka The EPICENTER at Edgewood.
Please identify any particular skills, experience, or education that has prepared you to work in your area of interest.

Much of our philosophy and worldview is shaped by the historical Christian faith. People who do not claim such a faith are not disqualified from volunteering with ECSC. But if you are willing to share, we would like to know a little about your convictions/practices in this regard.

If your life is guided by a relationship with Jesus, please briefly describe that relationship below.
Background
Statements

By submitting this form, I affirm that the information contained in this application is correct to the best of my knowledge. I, the undersigned, give my authorization to Edgewood Community Support Center (ECSC aka The EPICENTER at Edgewood) or its representatives to release any and all records and information relating to working with minors. ECSC may also contact my references. I authorize any references listed to give you any information they may have regarding my character and fitness for work with minors. I release all such references from liability from any damage that may result from such evaluations to you and I waive any right to inspect these references.

I authorize ECSC to perform a criminal records check for arrests, convictions, or other information the County Department of Corrections, the State Justice Cabinet, and any other local, state or federal criminal enforcement agency may have regarding me and release such information to ECSC.

I release ECSC and the above mentioned agencies from any liability or damages resulting from the release of this information. I waive any present or future claims of privacy resulting from this information for qualifications of volunteer work at ECSC. Moreover, I agree that, if my application for a volunteer position is accepted by ECSC 1) I will abide by the policies & procedures of ECSC and 2) I will refrain from inappropriate behavior and interactions with children and youth.

I understand that there may be occasions when Edgewood Community Support Center (ECSC, aka The EPICENTER at Edgewood) will want to use photographs or audio or video recordings from ECSC’s activities or events in which I participate. I grant to ECSC the right to include photographic, video, audio and other visual or audio portrayals of me taken during or in connection with ECSC activities or events in any medium of any nature whatsoever (including the right to edit, combine with other materials or create any type of derivative thereof) for the purpose of advertising, publicity, promotions, or otherwise, without compensation to me. Such grant shall include the unrestricted right to copy, revise, distribute, and display photographs, images, films, tapes, drawings or recordings in any type of media (including, but not limited to, the Internet). I consent to the use by ECSC of my voice, testimonial, comments and/or narrative writing, in any manner, free of charge, in any form or media, including, but not limited to, the Internet. I understand the wording of any testimonial, comments and/or narrative writing may be edited or altered, provided that the sense and meaning are not materially changed. I agree that all rights, title and interest therein shall be ECSC’s sole property, free from any claims by me or any person deriving any rights or interest from me. I release ECSC and its agents and assigns from any and all claims which may arise out of or are in any way connected with such use.

Once you submit this form, you will be given a link to a secure service to authorize a background check. This second step is required to complete your application.