Adult Staff Application

Prior to filling out application you must have downloaded and read completely the staff/workshop application to understand criteria and responsibilities of staff position and workshop presenters.
I have read the staff responsibilites:
First Name
Last Name
Home Address
City
State
Zip Code
Country
Phone (HOME)
Phone (CELL)
FAX
EMAIL
Date of Birth (MM/DD/YYYY)
Sex
Place of Employment
Position/Title
Employment Address
Employment City
Employment State
Employment Zip
College Degree / Work Experience
Been on adult staff before?
Attended a Y2Y Conference Before?
If Yes, please list conferences
Why would you like to be on adult staff?
Describe your experience with teens.
Please indicate which conferences you are applying for and rank them in order of preference.
International's Conference
Western States Conference
Eastern States Conference
Please give a brief, yet creative biography of yourself that will be included in conference materials if you are selected.
Bio:
What school/group are you representing?
Which Conference are they attending?
Have you ever had a background check, with fingerprinting, for your job/volunteer work?
Background Check
Have you ever been convicted of a felony, or any sexual related offense (abuse, molestation, etc.)?
Felony Conviction
If yes, please describe:
I am under 21 and adhering to a no-use (including alcohol) lifestyle, or over the age of 21.
Please initial, if yes:
I attest that I have no personal alcohol or other drug use problem (and if in recovery, I have been in recovery for at least one year), and the information contained in this form is true and accurate. If this is accurate, please click yes below.
Confirmation
I am uncertain at this time if I will be available for the conference(s) I have marked. Please contact me in May to see if I am still available, or I will contact you if I know before that time.
Contact?