Volunteer Application Form

Availability Information *

Why do you wish to work with this program? *
At most two sentences.
Please state similar work experiences. *
Do you have any special certifications, knowledge, experience? (e.g. Special Needs, AP Level Classes)

Yes No
What are other interests or skills that we should know about? *
If yes, explain
Areas of Service

Academic Tutoring Mentoring Performing Arts (drama, dance, music) Event Planning Counseling Fundraising Life Management and Career Preparation Parent Education
Age of Youth that You Prefer to Assist

Elementary Middle School High School No preference
Have you been vaccinated for COVID-19?

Yes, received both vaccinations Yes, received one vaccination and the other is scheduled No
Do you have transportation?

Yes No
Do you have any criminal convictions?

Yes No
If yes, explain.
I hereby acknowledge that the information given above is accurate and I do not have any disease or medical condition that prevents my participation in the activities.
Volunteer Candidate Signature *

Clear