The Salvation Army Location: _____________ _ AOK DIVISION- Tulsa Area Command Volunteer Application Date of Application: ________ _

•••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••

Name: ___________________ Email: ____________________ _

Phone:------------------ Cell Phone: ------------------

I want to receive monthly volunteer updates via text messaging including: volunteer needs, event needs and other major need . YES NO

Street Address: --------------------------------------

City:------------------------- State: _____ _ Zip: _____ _

Emergency Contact: Emergency Phone: -----------

••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••• PLEASE NOTE: This form is designed for applicants that will be volunteering for various positions. Please include all information requested. Answer questions to the best of your ability. All information will be treated confidentially.

TYPE OF VOLUNTEER WORK:

Indicate the position in which you are applying: --------------------------­

Do you have any commitments to another company that might affect your volunteer work with us, including confidentiality, non-disclosure or non-competition agreements? YES NO

Summarize any special training, skills, licenses, certificates and/or characteristics of yourself that might qualify you for the position for which you are applying:

GENERAL INFORMATION:

Are you below the age of 18?

Have you ever been convicted of a felony?

YES

YES

NO

NO

If you are to be seriously considered for a volunteer position with The Salvation Army, you may be asked for your

authorization to run a background check and/or credit check. Would you be willing to authorize this? YES NO

Within the last two years, have you been convicted of a misdemeanor which resulted in imprisonment? YES NO

If yes to either, please explain: (Note: A conviction will not necessarily disqualify you from the position requested)

Have you previously applied for employment here? YES NO Ifyes,when? ___________ _

Have you previously been employed by The Salvation Army? YES NO If yes, where? ------------

"I certify that the information contained in this application is true and complete. I authorize investigation of all statements contained in this application and understand that any false or misleading statements or material omissions are cause for my inability to volunteer on behalf of The Salvation Army. I hereby authorize former and present employers/volunteer organizations, except as I have otherwise indicated on this application, as well as physician, references and other sources to provide or verify any information that they may have regarding me, my employment and/or volunteer service with them to The Salvation Army and release them from any liability arising from the furnishing of any employment/volunteer information. I further certify that I recognize that The Salvation Army is a church and agree that I will do nothing to undermine its religious mission."

Applicant Signature Date

Department Head Signature Date

~It~~- S T E R L I N G l$Wt1t"" l(nowWho You·r·~~ Hiring'

Consent lo Request Consumer Repot·( & Investigative Consumer Report Informati on

.___r--l.___- l.____.___.l'---'--[___.l··J -· I r·T ] [J-[J L l [J~ I LI"'"-'---JI,~l'--' .. TI'---' _Applicant's First. Na~~~~ .. - - l.ast Name

I understand u·,at The Salvation Army ("COMPANY") will use Sterling InfoSystems Inc., 249 West 17th Street, New York, NY 10011, (877) 424-2457 to obtain a consum~)r report and/or investigative consumer report ("Report") as ptlrt of the hi1·ing p1·ocess. I also understilnd that if 11ired, to the extent permitted by law, COMI'ANY may obtain further Reports tmm STERLING so as to update, renew o1· extend my employment.

r understand Sterling lnfoSystems Inc.'s ("STERLING") investigation may include obtaining information regarding my credit background, bankruptcies, lawsuits, judgments, paid tax liens, unlawful detainer actions, failure to pay spousal or child support, accounts placed for collection, character, general reputntlon, personal characteristics and stondard of living, driving record and criminill record, subject to any limitations imposed by ap[llicable federnl nnd state luw. I understnnd SLICh information may be obtaine(J tlrrough direct or indirect contact with former employers, schools, financial institutions, landlo1·ds and public agencies or other pNson$ who may lwve such knowl!'!dge. lf an investigative consumer repo1t is being requested, I understand such information may be obtained through any means, Including but not limited to personal inter·views with my acquaintances and/or associates or with other·s wtlom I am acquainted.

Tire nature and scope of the investigation SOlJght is indicated by U1e selected services below: (Employer Use Only)

IX1 Crlrninal Background Ctreck

~ SSN Trace

0 MotOI' Vehicle l<epol"t

0 Consumer Credit Report

D Other PletJse List:

D D D D

f.dlJCation verification

fmployment Veriflc~tlon

PCI'Sonal Reference

Professional l.icense/Certificallon

~ Sex Offender Sea1 ch

D OFAC/Terrorist W~tcl1 List

D Fraud & Abuse Conlrol Info System {FACIS@)

D Office ot ln5pector General Sunctions {OlG)

1 acknowledge receipt of tire attached summilry of my rights under the Fair Credit Reporting Act and, <IS required by law, any related state summary of rigl1ts (collectively "Summaries of Rights").

This consent will not affect my ability to question or dispute the accuracy of any information cont<Jined in a F(eport. I understand if COMPANY makes a conditional decision to disqualify me based all or in part on my Report, I will be provided with a copy of the Report and a nether copy of the Summaries of Rigl1ts, and if I disagree with the accuracy of the purported disqualifying information in the Report, ! rnust not1fy COMPANY within five business days of rny receipt of tl1e Report thilt I am chollenginCj the accuracy of such information witl1 STERLING.

I 11ereby consent t:o this Investigation and authorize COMPANY to procure a Report on my b;1c:kground.

In order to verify my identity for the purposes of Report preparation, r am voluntarily relf!asing my date of birth, sor.ial security number <Jnd the other information and fully understand that all employment decisions are based on legitimate non-cliscriminatory reasons.

Tl1e name, address and telephone number of the neurest unit of the consumer reporting agency designated to h<~nclle inquil·ies reSJarding the investigative consumer report is;

Sterling lnfosysterns, Inc. I 249 W 17111 St. 61h Floor, New York, NY 10011 1 877-424 .. 2457 I or 1 5750 West Oaks Boulevard, Ste. J.OO Rocklin, CA 95765 1 800·9'13·2589 1

0 Callfornla, Maine, Massachusetts, Minnesota, New Jersey & Oklahoma Applicants Only: I have the right to request a copy of any Repo1t obtained by COMPANY from STERLING by checking the box. (Check only if you wish to receive a copy)

0 California, Connecticut, Maryland, Oregon, Vermont and Washington State Applicants Only {AS APPLICABLE): l furtlier Llnderstand that COI'<1PANY will not obtain information about my credit history , credit worthiness, credit stancling, or crPdit capaCity unless: (i) the information is r·cquired by law; (ii) I am seeking employment with a financial institution (California, Connecticut <l11(1 Vermont only - In California the financial institution rnust bP. subject to Sections 6801 ··6809 of the U.S. Code <~nd in Vermont it must lle a fi11ancial institution as defined in U V.S.A.§ 11101(32) or il credit union as defined in 8 V.S.A. § 30101(5)); (iii) ram seeking employment with a financial institution that accepts deposits th<Jt are inSLirecJ by a federal agl'!ncy, o1· an <Jfflliate 01· subsidla1y of tl1e financial institution or a credit union share guaranty cor[JOI'iltion thot: is approvecl by tile M<rrylan<l Commissione1· of Financ1al Regulillion or an entity or an affiliate of the entity that is registered as an investment advisor with tiH" United Stat~s Sl!curitil~s ancl Excl1a11ge Commission (Marylund only); (iv) I arn seeking employment in a position which involve~ <Jccess to confidential finunr:ial information (Vennont only); (v) I am seeking employment In a position whicl1 requires <~ finnncial fiduciary responsibility to tl1e employer or a client of the employer, Including the authority to issue payments, collect rJ~bls, transfer monc:y, or enter Into contracts (Vermont only); (vi) COMPANY can demonstrate that the information is a valid unci reliable prerlicto1 of employee performance in the specific position being sought or held; (vii) I arn seeking employment in a position that involves access to iln employer's payroll information (Vermont only); (viii) the information is substantially job related, and the bona fide re<tsons tor using the information are disclosed to me in writing, {complete the question below) (Connecticut, M<1ryland, Oregon

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249 Wesl 17th Stmel. 6'" Floor, New York. NY 10011 • Telephone 877-424-2457 • Facsimile 646-53G-5239 9/2012

~)- S T E R L I N G -r J>RJNT CHARACTERS t .IKE THIS j lcor"~Ec r IN,cor1r;EcT ]

l<noli'.rWho You'1·c Hiri119! I ABCDE 98765 • _ (I) ® (,;,;>

and Washington only);(ix) I am seeking employment ~sa covered low enforcement. officer, emergency m~dical rersonnel, fi1·efi9hter police officer, peace officer or other law enforcement position (California, Oregon und Vermont only - in Oregon the police or peace officer position must be sought with a federally insured b<1nk or credit union and in Vermont the law enforcement officer position must be as defined in 20 V.S.A. § 2358, the emergency medical personnel must be as defined in 2~ V.S.A. § ~651(6), and the firefighter position must be as defined in 20 V.S.A. § 3151(3)); (x) the COMPANY reasonably believes 1 have engaged in specific activity that constitutes a violation of law 1·elated to my employment (Connecticut only); (xi) I am seeking a position with the state Department of Justice (Califomia only); (xii) I am seeking a position i:lS an exempt managerial employee (California only); and/or (xiil)) J am seeking employment In a position (other than regular solicitation of credit card applications at a retilil establishment) that involves regular access to all of tile following pl'!rsonal information of any one person: bank or credit card account information, social security number, and date of birth, I am seeking employment in a position that requires me to be a named sign<~tory on the employer's bank or credit card or otl1erwlse aut110rlzed to enter Into financial contracts on behalf of the ~mployer, 1 am seeking employment in cl position that involves access to confidential or proprietary information of the Company or regular access to $10,000 or more in cash (CaliforniCJ only),

Bona fide reasons why COMPANY considers credit information Sllbstantia11y job related (complete if this is the sole basis for obtaining credit information) or in California and Vermont the COMPANY'S basis for the credit check.

NY Applicants Only: I also acknowledge that l have received the attached copy of Article 23A of New York's Correction Law. I further underst<Jnd that I may request a copy of any investigative consumer report by contacting STERI.ING. I further understand n1at I will be advised if any further cl1ecks are requested and providecl the name and address of the consumer reporting agency.

California Applicants and Residents: If I am applying for employment in California or reside in California, J understand I have tl1c right to visually inspect the files concerning me maintained by an investigative consumer reporting agency during normal business hours and upon reasonable notice. The inspection can be done In person, and, if I appear in person and furnisl1 proper identification; I am entitled to a copy of the file for a fee not to exceed U1e actual costs of duplication. I am entitled to be accornpaniod by one person of n1y choosing, who shall furnish reasonable identification. The inspection can also be done via certified mail if r make a written request, with proper identification, for wpies to be sent to a specified addressee. I can also request a summary of the information to be provided by telephone if I make a written request, with proper identification for lelephone disclosure, and the toll charge, if any, for tile telephone call is prepaid by or directly charged to me. l further understand that the investigative consumer reporting agency shall provide trained personnel to explain to me any of the information furnished to me; I shall receive from tl1e investigative consumer reporting agency a written explanation of any coded information contained in files maintained on ITH~. "Proper identification'' ilS used in this parawaph means information generally deemed sufficient to identify a person, including documents such as a valid driver's license, social security account number, military identification card <Jncl credit cards, I understand that I can access the following website lU11W.Di.tillD.Q)nfow_~ems.cQmLJ?rlY£1.(;Y. to view STERLING'S privacy practices, including infonnation with respect to STERUNG'S preparation and processing of investigative consumer reports and guidance as to whether my pe1·sonal in! ormation will be sent outside the United States or its ten·itories.

Signature: Today's Date:

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249 Wosl 1 i'th Slreet, 6"' Floor. New York, NY 10011 • Telephone 877-424-245'1• Facsin1ile 646-536-5239 09/2012

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www.slerlinginfosyslems.com Page 3 of 5 249 Wesl17lh Slroel, 611

' Floor, New York, NY 10011 • Telepl1one 877-424·2~57 • Facsimile 646-536·5239 09/2012

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249 West 17th Street, 6'" Floor, New York, NY 10011 • Telephone 677-421-245'1 • Facsimile 646·536-5239 09/2012