Form Center

By signing in or creating an account, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.

Intern-Application-VC-Online Fillable File

  1. Visitation Center (JPG)
  2. Greene County Family Visitation Center

    143 East Market Street, Xenia, Ohio 45385

    (937)-562-5687

    Fax: (937) 562-5691

    Email: gcvc@greenecountyohio.gov

  3. Interns and Volunteers must have a willingness to help the children and families of Greene County, have good communication skills, and the ability to work well with children of all ages.
  4. I am interested in
  5. Please list three professional references (other than relatives). List individuals who have knowledge about your skills and abilities, such as; co-workers, a volunteer supervisor, a pastor, academic professional, etc.:
  6. Do you speak a foreign language?
  7. Have you ever been convicted of a crime, other than a traffic violation?
  8. Do you consent to a routine check of your criminal record (if necessary)?
  9. Have you lived in Ohio for the past 5 years?
  10. Have you been involved professionally or personally with the following programs/agencies?
  11. Children Services Board (CSB)?
  12. Foster Care?
  13. Court System?
  14. CASA?
  15. Other agencies offering services to children?
  16. Employment History (beginning with current):
  17. I certify that the statements herein contained are true to the best of my knowledge. I understand that any question contained herein, or failure to completely answer any question contained herein, is cause for dismissal from service to Greene County Visitation Center. I further understand that a record check with police agencies may be conducted as part of the application process, and I give Greene County Visitation Center permission to make such a check in order to ensure my suitability for volunteer placement.
  18. I understand and agree that Greene County Family Visitation Center may make a thorough investigation of my past employment and activities, and I release from liability or responsibility all persons and organizations supplying such information. I also understand and agree that the information obtained may be used by Greene County Family Visitation Center in any way connected with my involvement in the program.
  19. Leave This Blank:

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