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Basic Information
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Name You Prefer
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I am interested in: (check all that apply)

 

[The following question is for refurbishing volunteers only]

Please list you prior experience with computer repair.

 

 

 

 

 

 

Mentoring

Workshops

Refurbishing
Other Information
How Did You Hear About C4K*

Newspaper- C-ville, The Hook, Daily Progress, etc.

Online- Search Engine, Craigslist, C4K site, etc.

Community Organization- MACAA, Public Schools, etc.

C4K Staff- Community Fair, , etc.

School- Madison House, Law, Piedmont, etc.

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Please give details about how you heard about us:

I hereby authorize Computers4Kids ("C4K") and/or ChoicePoint to make an independent investigation of my background, references, character, criminal or police records, including those maintained by both public and private organizations and all public records for the purpose of confirming the information contained on my application and/or obtaining other information which may be material to my qualifications for serving as a volunteer working with children in the programs administered by C4K.

I release Computers4Kids and/or ChoicePoint and any person or entity which provides information pursuant to this authorization, from any and all liabilities, claims or law suits in regard to the information obtained from any and all of the above referenced sources.

I certify that the following is my true and legal name and that all information contained herein is true and correct to the best of my knowledge.
Check Box For Authorization*