Background Check Disclosure
You are hereby notified that the YWCA of Minneapolis may obtain a
criminal background check for the purpose of evaluating you for certain
volunteer positions. An Informed Consent will be provided to you to complete and
sign upon application for specific positions that require a background
check, as determined by the YWCA of Minneapolis. You are entitled to obtain,
by written request, disclosure of the nature and scope of the report.
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The information I have provided is accurate and up-to-date. I understand that acceptance as a YWCA of
Minneapolis volunteer and assignement to a volunteer position is based on assessment by program staff and the
availability of a suitable position for me. I also understand that submitting this application does not
obligate me as a volunteer with the YWCA of Minneapolis.
I agree I do not agree
I give the YWCA of Minneapolis permission to take photos of me during my volunteer service for use in
publications and advertising. I release the YWCA of Minneapolis from the liability in the event of injury
during my volunteer activities.
I agree I do not agree
If you are under 18, please provide your parent/legal guardians name and phone number. We will need to contact him/her for consent.
Name: Phone:
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