BECOME A MEMBER

To become a member, please complete the application below and submit it for review.

Upon receipt of your application, you will be notified via email to submit information for a criminal background check (this only takes a few moments to complete).

Membership Requirements:

Must be 18 years or over.
Must not violate any of the SNPF Code of Conduct and Privacy Policy
Must complete and pass a criminal background check every five (5) years

VIEW MEMBERSHIP REQUIREMENTS

MEMBERSHIP APPLICATION

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PERSONAL INFORMATION

Last Name:

First Name:

Gender:

Are you over 18 years or older?

Address:

City:

State:

Zip Code:

Home Phone Number:

Cell Phone Number:

Email Address:

Occupation:

Employer:

Employer Address:

Manager:

Employer Phone Number:

Manager Email Address:

Are you proficient in any foreign language?

If so, what language(s)?

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COURT RECORD

Have you ever been arrested, charged, or summoned with any offense including but not limited to criminal violations, disorderly persons offenses, or ordinance violations?

Yes

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If the above answer is “yes” please complete the below information

Date:

Location:

Charge:

Disposition:

Details:

Date:

Location:

Charge:

Disposition:

Details:

Do you have any prior involvement or experience with Domestic Violence, either as a victim or the accused?

Yes

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If the above answer is “yes” please complete the below information below.

Date:

Location:

Charge:

Disposition:

Details:

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DRIVING RECORD

Do you have a valid driver's license?

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REASON FOR APPLYING FOR A VOLUNTEER POSITION

What, if any, has been your experience in Domestic Violence?

How did you hear about us and why do you want to volunteer for the foundation?

Do you grant consent for the Stephanie Nicole Parze Foundation to conduct a background check?

Yes

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If you do not grant consent to a background check, please know that your application will not be considered for a volunteer position with the Foundation.

I understand that my membership application is contingent upon the results of my background check. I also understand that willfully withholding information or making false statements on this application will be basis for dismissal from the Stephanie Nicole Parze Foundation. I agree to these conditions and I hereby certify that all my statements made by me on this application are true and complete, to the best of my knowledge.

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The Stephanie Nicole Parze Foundation (SNPF) in addition to email, will begin utilizing Text Messaging as a new method of communication effective January 1, 2025. Text messages will, when necessary, be sent to the cell phone number we have listed in your membership profiles. Text messages will not be sent out between the hours of 9:00 pm and 8:00 am, unless it is an emergency. (This does not apply to any response team members). Authorization to receive text messages is implied. Text Messaging consent is part of your membership application. By signing the application you give the SNPF implied consent to send such text messages.

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By checking this box, I attest that I have read the SNPF Code of Conduct and Privacy Policy

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I have read and understand the Member Requirements

Signature of Applicant:

Date:

BECOME A MEMBER

MEMBERSHIP APPLICATION

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