Name *
Name
Date
Date
Today's date
Address
Address
Phone
Phone
Referenes
Please list two adult references (no relatives) who will recommend you to be a Youth Court Volunteer
Reference 1 Name
Reference 1 Name
Reference 1 Address
Reference 1 Address
Reference 1 Phone
Reference 1 Phone
Reference 2 Name
Reference 2 Name
Reference 2 Address
Reference 2 Address
Reference 2 Phone
Reference 2 Phone
Youth Volunteer Agreement
I authorize the above references to release information which would help Youth Services to determine my suitability for participation in the Youth Court Program. This information may be obtained by phone, personal interview or written report from the references I have listed above. I understand that I must complete training, refer any Youth Court publicity to Youth Services Youth Court Coordinator, and be a good role model for my peers to represent Youth Court in an appropriate and professional manner.
Please type your full name.
Checkbox *
I agree this is my full name and that all the information given is true to my best ability. I also understand that this constitutes my legal signature.
I agree my typing my full name that the above name youth may participate in Youth Services Youth Court. I further understand that I may be contacted for confirmation.