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Volunteer Form - Adult

  1. In Case of Emergency:
  2. Personal Reference
  3. Criminal History Information
  4. Have you ever been convicted for a violation other than a minor traffic offense?*
  5. I hereby certify that the information on the above application is true and is complete to the best of my knowledge. My signature authorizes the City of Bridgeport to verify any information on this application and to secure any information needed to complete a background check.
  6. Leave This Blank:

  7. This field is not part of the form submission.