Restorative Justice Circle Community Volunteer Application

Name Date of birth Phone 1 Phone 2 Email Address City State Zip

Are you at least 18 years old?

Yes

No

If no, when will you turn 18

Are you a student?

Yes

No

If yes, what is the school

Have you been convicted of a felony within the last seven years?

Yes

No

If yes, please explain felony conviction

Do you presently have any criminal charges pending?

Yes

No

If yes, please explain pending criminal charges

Please include the names, contact information, and positions of three personal or professional references along with your completed application. Employment details not applicable or wish not to answer Employer Occupation Work address Work city Work state Work zip Business phone Fax Worship details not applicable or wish not to answer Place of worship Place of worship address City State Zip Business phone Fax Initial here to confirm you watched the overview video, It's In Our Hands

Date for confidentiality agreement

Date for release statement