FILLING PLAYGROUNDS, NOT PRISONS
Dunn Police Athletic & Activities League, Inc. 1501 S. Clinton Ave. / Post Office Box 1238 Dunn, N.C. 28335 Office 910-892-1873 / Fax 910-292-4046 www.dunnpal.org / Internet TV www.dpaltv.com
PAL Volunteer Board Application
Date of Application
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Name
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Date of Birth
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Email Address
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example@example.com
Sex
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Race
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Ethnicity
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Social Security
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Driver’s License
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State
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Address
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Home Address
Street Address Line 2
City
State / Province
Postal / Zip Code
State
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Zip
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Home Phone#
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Cell Phone #
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Work Phone#
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Previous Address
Previous Address
Street Address Line 2
City
State
Postal / Zip Code
Previous Address
Address
Street Address Line 2
City
State
Postal / Zip Code
Present Employer
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Name of Supervisor
Date of Employment
Work Address
City
State
Zip Code
Describe Position
References: Name 1
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Address
Phone Number
City
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State
Zip
References: Name 2
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Address
Phone Number
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City
State
Zip
References: Name 3
Address
Phone Number
City
State
Zip
Any falsified information that is placed on this application will be grounds for immediate termination and/or prosecution.*Also go online to https://dunnpal.org/volunteer/and complete the VOMO Volunteer managementsoftware to finish this application.
Chief of Police Clark White PAL Board Executive Director Capt. R. W. Rowland
Dunn Police Athletic & Activities League, Inc. 1501 S. Clinton Ave. / Post Office Box 1238 Dunn, N.C. 28335 Office 910-892-1873 / Fax 910-292-4046 www.dunnpal.org / Internet TV www.dpaltv.com
FILLING PLAYGROUNDS, NOT PRISONS
Please answer the following questions
Have you ever been arrested, charged or convicted of a crime?
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Have you ever been involved in an incident involving child abuse or neglect? If yes explain
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Have you ever had or do you have a problem with drugs and/or alcohol? If yes explain details
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Reason for applying to the board?
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What can you bring to the board that will help PAL and the youth?
Give number of years you will be willing to serve on the board: Give what positions you are willing to accept on the board president, VP, secretary, etc
Any previous board experience?
What experience do you have working with children?
Do you have any prior fundraising experience? (circle one) YES / NO
List any previous fundraising experience.
List any volunteer experience.
I (input your name below)
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money. I have a vested interest in my/this community and I hereby pledge $ (Circle One) Weekly / Monthly / Quarterly / Six Months / Yearly in the amount of
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money. I have a vested interest in my/this community and I hereby pledge $ (Circle One) Weekly / Monthly / Quarterly / Six Months / Yearly in the amount of
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understand this board position comes with devoted time, resources and to be paid yearly in until paid each year. Please consider this my monetary contribution along with me attending all board meetings and volunteering in other areas as needed to help support Dunn PAL and its mission.
Name of Applicant
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Applicant Signature
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Date
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Month
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Witness Signature
Chief of Police Clark White PAL Board Executive Director Capt. R. W. Rowland
Dunn Police Athletic & Activities League, Inc. 1501 S. Clinton Ave. / Post Office Box 1238 Dunn, N.C. 28335 Office 910-892-1873 / Fax 910-292-4046 www.dunnpal.org / Internet TV www.dpaltv.com
FILLING PLAYGROUNDS, NOT PRISONS
Consent / Release Form (To investigate background information) Dunn Police Athletic & Activities League, Inc. Post Office Box 1238 Dunn, N.C. 28335
Applicant’s Name
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Date of Birth
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Month
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Day
Year
Date
Social Security Number
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Male/Female
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Race
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Address
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City
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State
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Zip Code
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I , (type your name below) authorize and give consent for the Dunn Police Athletic & Activities League
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to obtain information regarding myself. This includes, but is not limited to:Employment Records/Employer’s References Criminal Background Check/Fingerprint Driver’s License Check Coaching Experience First-Aid Experience Personal References AddressesI authorize this information to be obtained either in writing or via telephone in connection with my application.
Name (printed)
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Applicant Signature
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Date
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Month
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Day
Year
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Witness Signature
Phone Number
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Chief of Police Clark White PAL Board Executive Director Capt. R. W. Rowland
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