Volunteer Application

If you are interested in volunteering with LSS Center for New Americans, please complete the volunteer application form below.

First Name
Middle Initial/Name
Last Name
Contact Information
Country
Address Line 1
Address Line 2
City
State
Postal Code
Best Contact Method
Gender
Have you lived in another state in the past 7 years?
If yes, please list 1 address from each state:
Employment Information
Country
Address Line 1
Address Line 2
City
State
Postal Code
Are you at least 18 years of age?
Are you receiving college credit or participating in the program as part of a college course?
Are you able to volunteer at least 6 months?
Do you speak additional language(s)?
Have you ever been convicted of a criminal offense?
Have you ever been convicted of a drug charge?
Have you ever been convicted of abuse, neglect, or assault?
I am volunteering as
How did you learn about LSS Center for New Americans?
Availability to volunteer
References

Please list three non-family, professional references.  Please provide complete information to expedite your application.

First Name
Last Name
First Name
Last Name
First Name
Last Name
Emergency Contact Information
First Name
Last Name
Disclosure and release of information authorizations

I authorize Lutheran Social Services of South Dakota and First Advantage a consumer reporting agency, to retrieve information from government agencies and law enforcement agencies at the federal, state (including the Minnesota Bureau of Criminal Apprehension), or county level, relating to my past activities, to supply any and all information concerning my background, and release the same from any liability resulting in providing such information.  The information received is limited to criminal history records. 

I hereby certify that all the statements and answers set forth on the application form are true and complete to the best of my knowledge, and I understand that if subsequent to my service in the Lutheran Social Services Center for New Americans Refugee and Immigration Programs any such statements and/or answers are found false or that information has been omitted, such false statements or omissions will be just cause for the termination of my service in the Refugee and Immigration Program.

I am willing that a photocopy of this authorization be accepted with the same authority as the original; and that this release will remain in effect throughout my time with LSS Center for New Americans.

First Name
Last Name

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