Volunteers for Fancy Cats Rescue Team often deal with members of the public, including children, who are interested in adopting cats. Accordingly, Fancy Cats asks that prospective adult volunteers provide the following information and at least two references. (Fancy Cats may conduct a background check on prospective volunteers, and may then require additional information from you, such as your Social Security number.)
Full Legal Name
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Other Names You Have Used:
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Date of Birth
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Please list addresses where you resided for the past five years:
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Please provide two references (other than family members):
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Have you ever been convicted of a felony?
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If you answered "yes", please provide the date of the conviction(s), the count(s), and the charges(s):
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Have you ever been convicted of a crime, other than a felony, involving or relating in any way to cruelty to animals, violence, misconduct with children, lying, cheating or stealing?
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If you answered "yes", please provide the date of the conviction(s), the count(s), and the charges(s):
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Have you ever been dismissed from or otherwise asked to leave a position of employment or volunteer position for your alleged misconduct with a co-worker, customer, client or other patron?
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If you answered "yes", please explain and provide the name and current telephone number of your former employer:
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I hereby certify that the information provided in this application is true and accurate.
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Date
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