Emergency Contact Information
Due to the nature of the services Spectrum of Solutions provides, each volunteer applicant must consent to criminal history background and driving record checks. For example, suppose a criminal history check indicates you have been convicted of or granted deferred adjudication or any other type of pretrial diversion for any criminal offense. In that case, Spectrum of Solutions will, on a case-by-case basis, determine your placement as a volunteer.
I agree to respect the confidential nature of all personal contact with consumers and adhere to all laws, rules, policies, and procedures pertaining to confidentiality regarding all records, files, and identifying information of consumers, former or potential, with whom I come into contact as a volunteer. I understand the violation of this confidentiality requirement can result in immediate dismissal from my volunteer assignment.
I agree to adhere to all Spectrum of Solutions policies and procedures pertaining to my volunteer placement by my signature. A copy of the Volunteer Policy is included on the Spectrum of Solutions website. I affirm that the information on this application is accurate to the best of my knowledge.
Please read the above following carefully before signing this application.
In connection with my application as a volunteer at Spectrum of Solutions, I understand that investigative inquiries on my background, per the Fair Credit Reporting Act and all state/federal laws, may be conducted. Including information about my character, abilities, work habits, mode of living, residency, immigration status, general reputation, performance, experience, and reasons for termination of past volunteer positions. I understand Spectrum of Solutions will make inquiries, including but not limited to: • Education • Driving History • Professional Licensing • Employment History • Nurse Aide Registry • Misconduct Registry • Criminal History • Med Aide Registry Furthermore, I understand that Spectrum of Solutions may request information from various federal, state, and other agencies that maintain records concerning my past criminal history, driving history, employment history, military history, civil and other matters. I understand that, according to the Fair Credit Reporting Act, I am entitled to know if my volunteer application is denied because of information obtained from a consumer reporting agency. Upon written request, I will be informed whether an investigative consumer report was requested and will be given information as to the nature and scope of this investigation and the name of the reporting agency or sources of information. I authorize, without reservation, all persons, and entities, including but not limited to businesses, former employers, law enforcement authorities, federal and state agencies, educational institutions, and private information bureaus or repositories contacted to furnish any or all of the above-mentioned information. In addition, I hereby release Spectrum of Solutions from any and all liability for damages arising from the investigation and disclosure of the requested information. I further release and discharge all liability from all companies, agencies, officials, officers, employees, and other persons who, in good faith, provide Spectrum of Solutions the above-mentioned information as requested in order to complete my background investigation successfully. I will allow a photocopy of this authorization to be as valid as the original.