{ binding displayValue, mode=oneTime }

Contact Information

Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{# pageNumbers}

Contact Information

Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Work Experience

Current Employer {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Position {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

How long have you been at your current job? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Previous Employer {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Position {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

How long did you work there? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Are you a student? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Volunteer Task Interest

Which tasks are you interested in helping with? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

References

To complete your application, you must provide two references (personal or employment related – if using a relative, please also list a person who is not a relative). Please send the link below to your references and have them fill out the online reference form. If any or both of your references do not have Internet access, please use the link at the bottom of this page to Contact US and we will make other arrangements. Before we can approve your application, both references must complete and return their form to the Center for Suicide Awareness.

I have read the above instructions and understand that I am responsible for sending my two references the link to the online reference form. {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Confirmation

I affirm that the information I have provided in this application form is true and correct to the best of my knowledge. I understand that misrepresentation, omission or falsification of facts in connection with this information may be sufficient cause for cancellation of consideration for volunteer service or termination whenever discovered. Volunteers may work with legally vulnerable adults and/or children. The following questions are required to comply with Minnesota law. Your answers will be handled in a confidential manner.

I affirm {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Have you ever been convicted or been given a suspended sentence, placed on probation, or been imprisoned because of a misdemeanor or a felony? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

I understand that as a condition of participation in this program that I will be required to provide the following: reference check information. Failure to cooperate or unsatisfactory results may result in withdrawal of an offer to participate in this volunteer program. As a condition of participation in this volunteer program, I hereby authorize the Center for Suicide Awareness to conduct an inquiry into any service-related information contained in this application.

I understand {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}