Please list 2 references that are familiar with your work and/or volunteer experience. (References should not be relatives):
Please Read carefully and sign below
I understand that any false, misleading or incomplete statements made as part of this application or omission of information may be considered sufficient reason for immediate dismissal.
I authorize appropriate personnel of the Agency to investigate my references and to make inquiries of courts and law enforcement agencies resulting from such investigations. Information furnished or recovered as a result of any inquiry will not necessarily preclude my acceptance into the program, but will be considered part of an overall evaluation of my qualifications.
I understand that nothing on the application is intended to create or imply a contractual relationship, if accepted. I understand that the volunteer/internship program is at will and can be terminated with or without reason at any time. Only a written agreement signed by the President & Chief Executive Officer can change my status. Upon termination, I authorize the release of reference information on my work and I hold the Agency harmless for the release of the information.
I understand that I will not be compensated for any hours worked for the Volunteer and/or Internship Programs at The Douglas Center.
Applicant Signature (typed):