Volunteer Information 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)

YesNo
What are other interests or skills that we should know about?*
If yes, explain
Areas of Service

Academic TutoringMentoringPerforming Arts (drama, dance, music)Event PlanningCounselingFundraisingLife Management and Career PreparationParent EducationSummer Enrichment CampBus Driving
Age of Youth that You Prefer to Assist

ElementaryMiddle SchoolHigh SchoolNo preference
Do you have transportation?

YesNo
Do you have any criminal convictions?

YesNo
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*