Name: Bach’s Lunch Concerts
Start: 2024-09-27T12:00:00-05:00
End: 2024-09-27T13:00:00-05:00
Location: Springer Cultural Center

Name*

First Last

Phone*

Cell/Daytime Phone

Email*

Address*

Street Address Address Line 2 City State ZIP Code

Preschool Preference*

Busy Bees – Springer Cultural Center

Creative Playtime – Springer Cultural Center

Art Smart – Springer Cultural Center

No Preference

Mondays:

Tuesdays:

Wednesdays:

Thursdays:

Fridays:

Saturdays:

Please list any related children in the preschool program. Use first and last names:

What type of background experience do you have working with children?*

Describe any previous experience that has enhanced your volunteer capabilities:*

Have you volunteered for the Champaign Park District before?*

Yes

If Yes, where and when:

Are you currently a student?*

Yes

If Yes, last grade completed:

Are you required to volunteer?*

Yes

If Yes, by whom:

List the name and phone number of two non-family personal references:

Name:*

Phone*

Name:*

Phone*

Comments:

Champaign Park District Criminal Background Clearance

The Champaign Park District complies with the State of Illinois statue (70 ILCS 1205/8-23) and requires a criminal background check on job applicants and volunteers. No park district shall knowingly employ a person who has been convicted (guilty) of one or more of several crimes of a sexual nature and/or illegal drug possession, or a Class X felony. Any other conviction(s) shall not automatically disqualify the applicant from consideration, but rather, the conviction(s) will be considered in relationship to the specific job. For a complete list of offenses, please contact the human resources manager.

Name*

First Middle Last

Date of Birth*

I agree to a criminal background check with the Illinois State police. To the best of my knowledge all statements I have given are accurate.*

*Complete the next three steps to electronically sign the document.

I agree.

Type your full name:*

Enter today's date:*

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