Volunteer Screening & Waiver

Habitat for Humanity of Wisconsin River Area upholds the highest standards of respect for the human rights of all people and supports a safe, ethical environment. We ask that volunteers authorize us to conduct a background check by completing this form as to ensure the safety of customers, staff, clients and other volunteers. Furthermore, all volunteers are required to complete a waiver of liability. If you have any questions or concerns about the purpose or use of these forms, please contact us via email or phone (608) 448-2888. Thank you.

First Name *

Last Name *

Email *

Date of Birth *

Address Line 1 *

Address Line 2

Phone *

City *

State * Alabama Alaska American Samoa Arizona Arkansas Armed Forces Americas Armed Forces Europe Armed Forces Pacific California Colorado Connecticut Delaware District of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming

Zip *

Emergency Contact *

Emergency Contact Phone *

Emergency Contact Email

Attached you will find the volunteer liability waiver and the full disclosure regarding background reports which includes your rights under the Fair Credit Reporting Act.

Policy - Background Screening for Staff & Key Volunteers - 9.12.2024.docx

2023 Volunteer Waiver.pdf