Shiftboard: DOC NYC Shiftboard Registration

Registration: DOC NYC Shiftboard

Welcome! Thank you for your interest in volunteering.

* required field

* First Name

* Last Name

* Address

* City

* State/Province

* Zip/Postal Code

* Email

* Primary/Home Phone

Other/Work Phone

Mobile/Cell Phone

* Have you ever been convicted of a felony or misdemeanor including motor vehicle related criminal convictions? Please do not include: arrests that did not lead to convictions; convictions that were expunged, erased, impounded or sealed; or youthful offender adjudications. A conviction in and of itself will not necessarily disqualify you from being considered for employment. Factors such as the number, nature and time of the offenses, the extent to which they relate to your suitability for employment in the position for which you are applying and any subsequent rehabilitation, among other things, will be taken into consideration.

Yes No

If "Yes" please explain

* Release from Liability Agreement
Refer to: Release Form

Yes

* Copyright Agreement
Refer to: Copyright Form

Yes

* Emergency Contact Name

* Emergency Contact Phone Number

Emergency Notes/Relationship, Instructions, etc,

Are you willing to use your own vehicle?

Yes No

Do you have a valid driver's license?

Yes No

Do you have valid car insurance?

Yes No

What vehicle type to you own?

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Thank you for your interest!

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